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Individual

JOHN VINCENT HALL JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
64167 HIGHWAY 41 STE C, PEARL RIVER, LA 70452-3638
(985) 250-9700
(844) 899-5208
Mailing address
1301 S SHIVERS ST, POPLARVILLE, MS 39470-3225
(601) 270-0038

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP08096
LA
363LF0000X
Family Nurse Practitioner
R889798
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2409964
LA
Enumeration date
08/06/2014
Last updated
09/09/2021
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