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General NPI Number Information
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NPI Number | 1063539260
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Entity Type | Organization
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Legal Business Name | GREGORY L. HALL M.D. INC
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 03/10/2014
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Provider Practice Location Address
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Address Line | 464 RICHMOND RD SUITE 201
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City | RICHMOND HEIGHTS
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State | OH
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Zip | 44143-2704
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Country | US
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Telephone | 216-881-5055
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Fax | 216-999-7758
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Provider Business Mailing Address
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Address Line | 464 RICHMOND RD SUITE 201
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City | RICHMOND HEIGHTS
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State | OH
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Zip | 44143-2704
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Country | US
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Telephone | 216-881-5055
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Fax | 216-999-7758
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GREGORY L HALL
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Credential | M.D.
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Telephone | 216-881-5055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 35063967
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License Number State | OH
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