Individual
ETHAN JAMES HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1633 W MAIN ST, LEBANON, TN 37087-3423
(615) 547-6930
Mailing address
2650 STRAWBRIDGE PL, OWENSBORO, KY 42303-1553
(270) 903-2102
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/03/2019
Last updated
08/14/2023
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