Provider Demographics
NPI:1316093347
Name:HALL, JEFFREY W (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:W
Last Name:HALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 BEARDSLEY LN
Mailing Address - Street 2:BLDG. C., SUITE 101
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-4945
Mailing Address - Country:US
Mailing Address - Phone:512-302-5558
Mailing Address - Fax:512-302-1216
Practice Address - Street 1:300 BEARDSLEY LN
Practice Address - Street 2:BLDG C., SUITE 101
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-4945
Practice Address - Country:US
Practice Address - Phone:512-302-5558
Practice Address - Fax:512-302-1216
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH62662086S0122X, 2086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG13421Medicare UPIN
TX00T40MMedicare ID - Type UnspecifiedMEDICARE NUMBER