Organization
HALL PODIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM DALE HALL DPM (OWNER)
(405) 826-0534
Entity
Organization
Contact information
Practice address
20 SW 132ND TERRACE, MOORE, OK 73170
(405) 826-0534
(405) 285-8921
Mailing address
PO BOX 8524, EDMOND, OK 73083-8524
(405) 826-0534
(405) 285-8921
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
126
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100116430A
—
OK
Enumeration date
09/19/2017
Last updated
09/19/2017
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