Provider Demographics
NPI:1891737904
Name:HALL, DANNY (MD)
Entity Type:Individual
Prefix:
First Name:DANNY
Middle Name:
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 1:13333 NORTHWEST FWY STE 540
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-6166
Mailing Address - Country:US
Mailing Address - Phone:800-708-9591
Mailing Address - Fax:210-634-1286
Practice Address - Street 1:2700 UNIVERSITY SQUARE DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-5513
Practice Address - Country:US
Practice Address - Phone:800-708-9591
Practice Address - Fax:210-634-1286
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1638082085R0202X
KY253642085N0904X, 2085R0202X, 2085U0001X, 2085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY25364OtherKY MEDICAL LICENSE
IN200467790Medicaid
KY64253644Medicaid
IN215510CMedicare ID - Type UnspecifiedPERRY CO RAD ASSOC
IN200467790Medicaid
KY64253644Medicaid
KY00195002Medicare PIN
KY0518503Medicare ID - Type UnspecifiedSOUTH CENTRAL KY OPEN MRI
KY25364OtherKY MEDICAL LICENSE
KY0716003Medicare ID - Type UnspecifiedCT AND OPEN MRI LAGRANGE
KY0913302Medicare ID - Type UnspecifiedPERRY CO RAD ASSOC