Provider Demographics
NPI:1679679856
Name:GARRON R. HALE, M.D., P.C.
Entity Type:Organization
Organization Name:GARRON R. HALE, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARRON
Authorized Official - Middle Name:RONALD
Authorized Official - Last Name:HALE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-946-4774
Mailing Address - Street 1:9070 E DESERT COVE DR
Mailing Address - Street 2:SUITE A-103
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6227
Mailing Address - Country:US
Mailing Address - Phone:480-946-4774
Mailing Address - Fax:480-946-4999
Practice Address - Street 1:9070 E DESERT COVE DR
Practice Address - Street 2:SUITE A-103
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6227
Practice Address - Country:US
Practice Address - Phone:480-946-4774
Practice Address - Fax:480-946-4999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6164207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ260878Medicaid
AZZ=========Medicare ID - Type Unspecified
D36970Medicare UPIN