1700860004 NPI number — ROBIN TATE HALL MD

Table of content: (NPI 1912487943)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700860004 NPI number — ROBIN TATE HALL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HALL
Provider First Name:
ROBIN
Provider Middle Name:
TATE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700860004
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/03/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2151 OLD ROCKY RIDGE RD STE 106
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VESTAVIA HILLS
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35216-7251
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-989-1080
Provider Business Mailing Address Fax Number:
205-989-1087

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1912 ALABAMA HWY 157
Provider Second Line Business Practice Location Address:
CULLMAN REGIONAL MEDICAL CENTER
Provider Business Practice Location Address City Name:
CULLMAN
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35058-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-737-2638
Provider Business Practice Location Address Fax Number:
256-734-6257
Provider Enumeration Date:
12/01/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207LP2900X , with the licence number:  MD.12965 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207L00000X , with the licence number: MD.12965 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3124 . This is a "HEALTHSPRING OF ALABAMA" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 050010504 . This is a "TRAVELERS MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2010168 . This is a "UNITED HEALTHCARE NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 631003288 . This is a "TRICARE (GROUP)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2451622001 . This is a "CIGNA EMPLOYER BENEFIT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 81812 . This is a "COMMERCIAL INS CO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3124 . This is a "MERIT HEALTH PLAN OF AL" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 2010168 . This is a "UNITED HEALTHCARE MEDIC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 293958 . This is a "FEDERAL BLACK LUNG PROG" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3124 . This is a "HEALTH STRATEGIES INC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 051081812 . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 81812 . This is a "WORKERS COMP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 81812 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: C70109 . This is a "VIVA HEALTH" identifier . This identifiers is of the category "OTHER".




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