Healthcare Provider Details

I. General information

NPI: 1366462913
Provider Name (Legal Business Name): RICHARD G HALL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 CHAMBERS ST
SOUTH OGDEN UT
84403-4591
US

IV. Provider business mailing address

PO BOX 27128
SALT LAKE CITY UT
84127-0128
US

V. Phone/Fax

Practice location:
  • Phone: 801-387-6200
  • Fax:
Mailing address:
  • Phone: 801-387-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4759477-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: