Provider Demographics
NPI:1275065823
Name:HALL, GEOFFREY (DO)
Entity type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:
Last Name:HALL
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-2504
Mailing Address - Country:US
Mailing Address - Phone:860-307-6192
Mailing Address - Fax:
Practice Address - Street 1:4709 CREEKSTONE DR STE 100
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-0016
Practice Address - Country:US
Practice Address - Phone:919-862-5782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2021-007842080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology