MEDICARE: BRADFORD S HALL MD

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
1	207W00000X	Ophthalmology Physician	10842	NH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	180039111	OTHER		MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	7177308	OTHER		AETNA
4	01Y002354NH01	OTHER	NH	ANTHEM
5	330441	OTHER	NH	CIGNA

General Provider Information

NPI Number	:	1255332169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRADFORD S HALL MD

Provider Business Mailing Address
First Line	:	248 PLEASANT ST
Second Line	:	STE 1600
City	:	CONCORD
State	:	NH
Zip	:	03301-2588
Country	:	US
Telephone Number	:	603-224-2020
Fax Number	:	603-228-0248

Provider Business Practice Location Address
First Line	:	248 PLEASANT ST
Second Line	:	STE 1600
City	:	CONCORD
State	:	NH
Zip	:	03301-2588
Country	:	US
Telephone Number	:	603-224-2020
Fax Number	:	603-228-0248

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	04/21/2020

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Directions to “ BRADFORD S HALL MD” Practice Location

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