| Joe I Hall Md Pc | |
|
107 J V Mangubat Drive Waynesboro TN 38485-2440 | |
| (931) 722-2800 | |
| (931) 722-9627 |
| Full Name | Joe I Hall Md Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 107 J V Mangubat Drive, Waynesboro, Tennessee |
| Authorized Official Name and Position | Sherri L Barber (CREDENTIALING) |
| Authorized Official Contact | 9317222800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Joe I Hall Md Pc Po Box 689 Waynesboro TN 38485-0689 Ph: (931) 722-2800 | Joe I Hall Md Pc 107 J V Mangubat Drive Waynesboro TN 38485-2440 Ph: (931) 722-2800 |
| NPI Number | 1023110392 |
|---|---|
| Provider Enumeration Date | 09/05/2006 |
| Last Update Date | 05/17/2019 |
| Medicare PECOS PAC ID | 1153223730 |
|---|---|
| Medicare Enrollment ID | O20040123000530 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023110392 | NPI | - | NPPES |
| 4060796 | Other | TN | BCBS OF TN |
| 3717844 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 25882 (Tennessee) | Primary |
| Provider Name | Patricia Diane Castleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164405221 PECOS PAC ID: 7012953870 Enrollment ID: I20050701000094 |
| Provider Name | Valerie Ann Hall-glass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447586508 PECOS PAC ID: 7517008618 Enrollment ID: I20100112000366 |
| Provider Name | Hillary Ray Cope |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003384645 PECOS PAC ID: 5193064715 Enrollment ID: I20190226002496 |
| Provider Name | Kaitlyn Anne Averett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780143297 PECOS PAC ID: 1759616311 Enrollment ID: I20190718001740 |
Family Health Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 J V Manguat Dr, Waynesboro, TN 38485 Phone: 931-722-2800 Fax: 931-722-9627 | |
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Waynesboro Clinic, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 206 Clifton Tpke, Waynesboro, TN 38485 Phone: 931-722-3677 Fax: 931-722-9052 |