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NPI Code Detail

MEDICARE: MR. TIMOTHY R HALL MD

MEDICARE: MR. TIMOTHY R 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
1208000000XPediatrics Physician200100885NC
2208000000XPediatrics PhysicianMD60217406WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275539660
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TIMOTHY R HALL MD
Provider Business Mailing Address
First Line : 7554 15TH AVE NW
Second Line : BALLARD PEDIATRIC CLINIC
City : SEATTLE
State : WA
Zip : 98117
Country : US
Telephone Number : 206-783-9300
Fax Number : 206-588-0531
Provider Business Practice Location Address
First Line : 7554 15TH AVE NW
Second Line : BALLARD PEDIATRIC CLINIC
City : SEATTLE
State : WA
Zip : 98117
Country : US
Telephone Number : 206-783-9300
Fax Number : 206-588-0531
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 03/07/2013

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