Provider Demographics
NPI:1215961180
Name:HALL, JOHN ZACHARIAH II (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ZACHARIAH
Last Name:HALL
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:217 TURNER DR STE F
Mailing Address - Street 2:
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27320-5754
Mailing Address - Country:US
Mailing Address - Phone:336-342-6060
Mailing Address - Fax:336-342-6068
Practice Address - Street 1:217 TURNER DR STE F
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-5754
Practice Address - Country:US
Practice Address - Phone:336-342-6060
Practice Address - Fax:336-342-6068
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-00668207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5907415Medicaid
NCI63244Medicare UPIN
NC2053325Medicare PIN