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NPI Code Detail

MEDICARE: DR. KELLI G HALL M.D.

MEDICARE: DR. KELLI G HALL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208M00000XHospitalist Physician01040811IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043299589
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KELLI G HALL M.D.
Provider Business Mailing Address
First Line : 250 E LIBERTY ST
Second Line : SUITE 801
City : LOUISVILLE
State : KY
Zip : 40202-1530
Country : US
Telephone Number : 502-587-9596
Fax Number : 502-585-2831
Provider Business Practice Location Address
First Line : 1850 STATE ST
Second Line :
City : NEW ALBANY
State : IN
Zip : 47150-4990
Country : US
Telephone Number : 812-944-7701
Fax Number : 812-949-5473
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2006
Last Update Date : 12/04/2020

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Directions to “ DR. KELLI G HALL M.D.” Practice Location

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