Individual
MR. DWIGHT M HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
300 WILSON ST, HENDERSON, TX 75652-5956
(903) 657-7541
(903) 596-7541
Mailing address
1110 TURNER DR, LONGVIEW, TX 75601-6750
(903) 720-1459
(903) 720-1459
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
47045
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
088614504
—
TX
01
—
85006U
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/20/2005
Last updated
04/03/2014
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