Healthcare Provider Details

I. General information

NPI: 1215062559
Provider Name (Legal Business Name): DAN EUGENE HALE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9123 CROSS PARK DR SUITE 200
KNOXVILLE TN
37923-4552
US

IV. Provider business mailing address

9123 CROSS PARK DR SUITE 200
KNOXVILLE TN
37923-4552
US

V. Phone/Fax

Practice location:
  • Phone: 865-670-0039
  • Fax: 865-670-0127
Mailing address:
  • Phone: 865-670-0039
  • Fax: 865-670-0127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberDO301
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: