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NPI Code Detail

MEDICARE: GREGORY L. HALL M.D. INC

MEDICARE: GREGORY L. HALL M.D. INC
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
1305R00000XPreferred Provider Organization35063967OH

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 : 1063539260
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREGORY L. HALL M.D. INC
Provider Business Mailing Address
First Line : 464 RICHMOND RD
Second Line : SUITE 201
City : RICHMOND HEIGHTS
State : OH
Zip : 44143-2704
Country : US
Telephone Number : 216-881-5055
Fax Number : 216-999-7758
Provider Business Practice Location Address
First Line : 464 RICHMOND RD
Second Line : SUITE 201
City : RICHMOND HEIGHTS
State : OH
Zip : 44143-2704
Country : US
Telephone Number : 216-881-5055
Fax Number : 216-999-7758
Authorized Official
Title or Position : PRESIDENT
Name : DR. GREGORY L HALL
Credential : M.D.
Telephone Number : 216-881-5055
Provider Enumeration Date : 03/23/2007
Last Update Date : 03/10/2014

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