Provider Demographics
NPI:1063476471
Name:HALLS, ALBERT J (MD)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:J
Last Name:HALLS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 159
Mailing Address - Street 2:20306 BADGER LANE
Mailing Address - City:ONLEY
Mailing Address - State:VA
Mailing Address - Zip Code:23418-0159
Mailing Address - Country:US
Mailing Address - Phone:757-787-7374
Mailing Address - Fax:757-787-4513
Practice Address - Street 1:20306 BADGER LANE
Practice Address - Street 2:
Practice Address - City:ONLEY
Practice Address - State:VA
Practice Address - Zip Code:23418-0159
Practice Address - Country:US
Practice Address - Phone:757-787-7374
Practice Address - Fax:757-787-4513
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2014-04-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE17503207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
277804Medicare ID - Type Unspecified
E07355Medicare UPIN