Doctor Name: | JOSEPH HALE |
NPI Number: | 1003899253 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA |
License Number: | 001784 |
Business Practice Address: | 1765 Old West Broad St Bldg 2, Ste 200 Athens, GA - 306062853 |
Business Phone Number: | 7065491663 |
Business Fax Number: | 7065468792 |
Mailing Address: | 1765 Old West Broad St, Bldg 2, Ste 200 ATHENS |
State: | GA |
Postal Code: | 306062853 |
Phone Number: | 7065491663 |
Fax Number: | 7065468792 |
NPI Enumeration Date: | 11/22/2005 |
NPI Last Update Date: | 03/07/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 001784 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |