Active NPI
Donald S Hall Jr., MD
- Ophthalmology Physician
- Vicksburg, MS
National Provider Identifier
1831106475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 06727
- Practice address
- 3303 Indiana Ave
Vicksburg, MS 39180 - Phone
- (601) 636-1851
- Fax
- (601) 636-1889
- NPI assigned
- Aug 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 06727 | MS | Primary |
Addresses
Primary practice location
3303 Indiana Ave
Vicksburg, MS 39180
Mailing address
3303 Indiana Ave
Vicksburg, MS 39180
Phone (601) 636-1851
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00016716 | Medicaid | MS | |
| 1027740 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06727 | MS | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378339200000",
"number": "1831106475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3303 INDIANA AVE",
"city": "VICKSBURG",
"state": "MS",
"postal_code": "39180",
"telephone_number": "601-636-1851",
"fax_number": "601-636-1889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3303 INDIANA AVE",
"city": "VICKSBURG",
"state": "MS",
"postal_code": "39180",
"telephone_number": "601-636-1851",
"fax_number": "601-636-1889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "DONALD",
"middle_name": "S",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-02",
"last_updated": "2013-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MS",
"license": "06727",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00016716",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1027740",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vicksburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.