Provider Demographics
NPI:1184899981
Name:HALL, ISAAC ELI (MD, MS)
Entity type:Individual
Prefix:DR
First Name:ISAAC
Middle Name:ELI
Last Name:HALL
Suffix:
Gender:M
Credentials:MD, MS
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Mailing Address - Street 1:1010 THREE SPRINGS BLVD STE 255
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-8296
Mailing Address - Country:US
Mailing Address - Phone:970-764-3825
Mailing Address - Fax:203-785-7068
Practice Address - Street 1:1010 THREE SPRINGS BLVD STE 255
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-8296
Practice Address - Country:US
Practice Address - Phone:970-764-3825
Practice Address - Fax:970-764-3839
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COCDR.0001719207RN0300X
NMMD2024-0472207RN0300X
UT9505136-1205207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology