Organization
SOUTHSIDE MEDICAL ASSOCIATES P.C
Active
Organization
SOUTHSIDE MEDICAL ASSOCIATES P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHERRY LENE HALL M.D (M.D)
(434) 575-6300
Entity
Organization
Contact information
Practice address
2202-A BEECHMONT ROAD, SOUTH BOSTON, VA 24592-2547
(434) 575-6300
(434) 575-8300
Mailing address
2202-A BEECHMONT ROAD, SOUTH BOSTON, VA 24592-2547
(434) 575-6300
(434) 575-8300
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101023654
VA
207R00000X
Internal Medicine Physician
010141405
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005880769
—
VA
05
—
005880777
—
VA
01
—
110244239
RR MEDICARE
VA
01
—
110244240
RR MEDICARE
VA
01
—
20602
OPTIMA
—
01
—
44111
OPTIMA
—
Enumeration date
09/19/2006
Last updated
07/14/2009
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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