Provider Demographics
NPI:1407842651
Name:HALFHILL, HAROLD L II (MD)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:L
Last Name:HALFHILL
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 139
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47701-0139
Mailing Address - Country:US
Mailing Address - Phone:812-471-1591
Mailing Address - Fax:812-471-6650
Practice Address - Street 1:2501 KENTUCKY AVE
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-3813
Practice Address - Country:US
Practice Address - Phone:800-467-2392
Practice Address - Fax:812-471-6650
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY288732085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64010770Medicaid
KY0502610Medicare ID - Type Unspecified
KY0502410Medicare ID - Type Unspecified
KY0536410Medicare PIN
G08711Medicare UPIN
KY0502510Medicare ID - Type Unspecified
KY00503049Medicare PIN
KY00151047Medicare PIN
KYP00830122Medicare PIN