Provider Demographics
NPI:1205129798
Name:HALL, DREW
Entity type:Individual
Prefix:
First Name:DREW
Middle Name:
Last Name:HALL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 E WARNER RD STE 127
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-3057
Mailing Address - Country:US
Mailing Address - Phone:480-874-7331
Mailing Address - Fax:480-865-2753
Practice Address - Street 1:690 E WARNER RD STE 127
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-3057
Practice Address - Country:US
Practice Address - Phone:480-874-7331
Practice Address - Fax:480-865-2753
Is Sole Proprietor?:No
Enumeration Date:2011-05-17
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10040643207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine