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Organization

PATHOLOGY ASSOCIATES OF BOONE PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRENT DWAYE HALL M.D. (PRESIDENT)
(828) 262-4106
Entity
Organization

Contact information

Practice address
336 DEERFIELD RD, BOONE, NC 28607-5008
(828) 262-4100
Mailing address
PO BOX 1867, BLUEFIELD, WV 24701-5867

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
34026
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
890219F
NC
Enumeration date
04/11/2006
Last updated
04/04/2018
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