Provider Demographics
NPI:1215651674
Name:HALL, MARK ARTHUR
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:ARTHUR
Last Name:HALL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 BROADVIEW CT
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-8144
Mailing Address - Country:US
Mailing Address - Phone:614-209-0635
Mailing Address - Fax:
Practice Address - Street 1:446 BROADVIEW CT
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062-8144
Practice Address - Country:US
Practice Address - Phone:614-209-0635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator