Provider Demographics
NPI:1629091855
Name:HALL, DANNY RAY (MD)
Entity Type:Individual
Prefix:DR
First Name:DANNY
Middle Name:RAY
Last Name:HALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1100 ENGLAND DRIVE
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-0924
Mailing Address - Country:US
Mailing Address - Phone:931-528-7531
Mailing Address - Fax:931-520-0413
Practice Address - Street 1:1503 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-5967
Practice Address - Country:US
Practice Address - Phone:931-484-6196
Practice Address - Fax:931-456-1047
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD7099207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1598817017OtherNPI
TN444-7818Medicaid
TN3376524OtherMEDICARE PTAN
TNBO2775Medicare UPIN
TN3376524OtherMEDICARE PTAN