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NPI Code Detail

MEDICARE: TIFFANY HALL M.D.

MEDICARE: TIFFANY HALL M.D.
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
1207R00000XInternal Medicine Physician36781TN
2208000000XPediatrics Physician36781TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
199182OTHERARBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
44108593OTHERTNBCBS

General Provider Information

NPI Number : 1598780546
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY HALL M.D.
Provider Business Mailing Address
First Line : PO BOX 1000
Second Line : DEPT 362
City : MEMPHIS
State : TN
Zip : 38148-0362
Country : US
Telephone Number : 901-367-9001
Fax Number : 901-255-5223
Provider Business Practice Location Address
First Line : 3725 CHAMPION HILLS DR STE 2000
Second Line :
City : MEMPHIS
State : TN
Zip : 38125-0502
Country : US
Telephone Number : 901-367-9001
Fax Number : 901-565-8787
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 10/14/2014

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