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Individual

DR. JUSTIN GLENN HALE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
300 EAST HOSPITAL ROAD, FORT GORDON, GA 30905
(706) 787-4657
Mailing address
300 EAST HOSPITAL ROAD, FORT GORDON, GA 30905

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
87608
GA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
87608
MEDICAL LICENSE NUMBER
GA
Enumeration date
06/12/2019
Last updated
03/05/2026
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