Provider Demographics
NPI:1417953019
Name:HALL, ROY R (MD)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:R
Last Name:HALL
Suffix:
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 1:2110 OVERLAND AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6447
Mailing Address - Country:US
Mailing Address - Phone:406-969-6310
Mailing Address - Fax:406-206-5100
Practice Address - Street 1:2110 OVERLAND AVE STE 102
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6447
Practice Address - Country:US
Practice Address - Phone:406-969-6310
Practice Address - Fax:406-206-5100
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10706207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1417953019Medicaid
MT0000093788OtherBCBS
MT011002409Medicare UPIN
MT1417953019Medicaid