MEDICARE: MICAH D HALE D.O.

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	005389	AZ
2	207QA0401X	Addiction Medicine (Family Medicine) Physician	20A-8534	CA
3	2083A0300X	Addiction Medicine (Preventive Medicine) Physician	5389	AZ
4	207QA0401X	Addiction Medicine (Family Medicine) Physician	5389	AZ
5	207Q00000X	Family Medicine Physician	20A8534	CA
6	207P00000X	Emergency Medicine Physician	20A8534	CA
7	2083A0300X	Addiction Medicine (Preventive Medicine) Physician	20A-8534	CA

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

NPI Number	:	1972506616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICAH D HALE D.O.

Provider Business Mailing Address
First Line	:	PO BOX 27646
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85255-0144
Country	:	US
Telephone Number	:	831-818-9833
Fax Number	:

Provider Business Practice Location Address
First Line	:	9700 N 91ST ST STE A115
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-5036
Country	:	US
Telephone Number	:	623-246-4900
Fax Number	:

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

Provider Enumeration Date	:	05/25/2005
Last Update Date	:	05/23/2026

9700 N 91ST ST STE B108
SCOTTSDALE, AZ
85258-5036

Practice Phone: 480-534-4544
Practice Fax: 602-258-8510