Provider Demographics
NPI:1306894530
Name:HALL, WILLIAM TUTTLE (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:TUTTLE
Last Name:HALL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1451
Mailing Address - Street 2:
Mailing Address - City:NAGS HEAD
Mailing Address - State:NC
Mailing Address - Zip Code:27959-1451
Mailing Address - Country:US
Mailing Address - Phone:252-480-1001
Mailing Address - Fax:252-480-0196
Practice Address - Street 1:107 DOWITCHER STREET
Practice Address - Street 2:
Practice Address - City:NAGS HEAD
Practice Address - State:NC
Practice Address - Zip Code:27959-0000
Practice Address - Country:US
Practice Address - Phone:252-480-1001
Practice Address - Fax:252-480-0196
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3116111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89085PJMedicaid
NC2456355Medicare ID - Type UnspecifiedCHIROPRACTIC
NC89085PJMedicaid