Healthcare Provider Details

I. General information

NPI: 1003220948
Provider Name (Legal Business Name): BRADLEY HALL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2014
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 ND AND EMILE STREET UNIV OF NEBRASKA CTR DEPARTMENT OF GENERAL SURGERY
OMAHA NE
68198-3280
US

IV. Provider business mailing address

42 ND AND EMILE STREET UNIV OF NEBRASKA CTR DEPARTMENT OF GENERAL SURGERY
OMAHA NE
68198-3280
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-4300
  • Fax: 402-559-6749
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number7238
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number23259
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: