Provider Demographics
NPI:1861814501
Name:ROBERT HALL MD LLC
Entity Type:Organization
Organization Name:ROBERT HALL MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LESLIE
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-214-6671
Mailing Address - Street 1:PO BOX 108
Mailing Address - Street 2:
Mailing Address - City:COMMERCIAL POINT
Mailing Address - State:OH
Mailing Address - Zip Code:43116-0108
Mailing Address - Country:US
Mailing Address - Phone:614-214-6671
Mailing Address - Fax:
Practice Address - Street 1:11 JOHN LLOYD EVANS MEMORIAL DR STE 400
Practice Address - Street 2:
Practice Address - City:NELSONVILLE
Practice Address - State:OH
Practice Address - Zip Code:45764-2523
Practice Address - Country:US
Practice Address - Phone:614-599-1826
Practice Address - Fax:614-416-0345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-15
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35085094208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H290880OtherMEDICARE
OH0098047Medicaid