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1952342636

NPI Code Detail

MEDICARE: BROOKE T HALL MD

MEDICARE: BROOKE T 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
1	207R00000X	Internal Medicine Physician	04-30259	KS
2	207R00000X	Internal Medicine Physician	MD26770	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	11308526	OTHER	OR	CAQH ID

General Provider Information

NPI Number	:	1952342636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE T HALL MD

Provider Business Mailing Address
First Line	:	PO BOX 1420
Second Line	:
City	:	REDMOND
State	:	OR
Zip	:	97756-0400
Country	:	US
Telephone Number	:	541-706-2949
Fax Number	:	541-706-2991

Provider Business Practice Location Address
First Line	:	2200 NE NEFF RD STE 302
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97701-4279
Country	:	US
Telephone Number	:	541-706-2949
Fax Number	:	541-706-2991

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	08/30/2023

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Directions to “ BROOKE T HALL MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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