Provider Demographics
NPI:1992959399
Name:JONATHAN S HALL MD PA
Entity type:Organization
Organization Name:JONATHAN S HALL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-528-5941
Mailing Address - Street 1:6006 49TH ST N
Mailing Address - Street 2:SUITE 330
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709-2148
Mailing Address - Country:US
Mailing Address - Phone:727-528-5941
Mailing Address - Fax:727-528-5942
Practice Address - Street 1:6006 49TH ST N
Practice Address - Street 2:SUITE 330
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-2148
Practice Address - Country:US
Practice Address - Phone:727-528-5941
Practice Address - Fax:727-528-5942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-12
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93949207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty