JACQUELYN HALL-DAVISM.D. LTD NPI 1699173542

NPI Information

NPI: 1699173542
Provider Name: JACQUELYN HALL-DAVIS,M.D. LTD
Classification: Psychiatry & Neurology - 2084P0804X
Entity Type: Organization

Specialization: Child & Adolescent Psychiatry

Address:
1669 WINDHAM WAY
SUITE B
O FALLON, IL
ZIP 62269
Phone: (618) 622-9240
Get Directions

JACQUELYN HALL-DAVIS,M.D. LTD is a child and adolescent psychiatry psychiatry neurology in O Fallon, IL. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. JACQUELYN HALL-DAVIS,M.D. LTD NPI is 1699173542. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1669 WINDHAM WAY
SUITE B
O FALLON, IL
ZIP 62269-072
Phone: (618) 622-9240
Fax: (618) 622-9241

The provider's authorized official is Jacquelyn Hall-davis .
The authorized official title is President and has the following contact phone number (618) 622-9240.

The enumeration date for this NPI number is 12/9/2014 and was last updated on 12/9/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	036080270	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	540653	OTHER	ILLINOIS	TRICARE
2	036080270	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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