Provider Demographics
NPI:1679515431
Name:HALL, NATHAN J (MD)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:J
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 1:104 WOODMONT BLVD
Mailing Address - Street 2:SUITE LL50
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2382
Mailing Address - Country:US
Mailing Address - Phone:615-386-2300
Mailing Address - Fax:615-386-2399
Practice Address - Street 1:4230 HARDING ROAD
Practice Address - Street 2:SUITE 400
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-297-2700
Practice Address - Fax:615-386-2399
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN40682207R00000X
TNMD40682207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1575167OtherCOVENTRY
TNP00344294OtherMEDICARE RR
KY7100063650Medicaid
TN110083627OtherUSA PPO-GEHA
TN10080077OtherAMERIGROUP
TN1238719OtherAETNA
TN3815294Medicaid
TN4134267OtherBLUE CROSS OF TN
TN1261629OtherMULTIPLAN/PHCS
TN2713882OtherUNITED HEALTH CARE
TN7085607OtherCIGNA
TN10080077OtherAMERIGROUP
TN1238719OtherAETNA
161962Medicare UPIN