Provider Demographics
NPI:1265531651
Name:HALL, STEVEN E (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:E
Last Name:HALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:STEVEN
Other - Middle Name:EDGAR
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:700 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:TN
Mailing Address - Zip Code:38382-3319
Mailing Address - Country:US
Mailing Address - Phone:731-855-3585
Mailing Address - Fax:731-855-9745
Practice Address - Street 1:700 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:TN
Practice Address - Zip Code:38382-3319
Practice Address - Country:US
Practice Address - Phone:731-855-3585
Practice Address - Fax:731-855-9745
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28290207P00000X, 207Q00000X
WI3891207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3147103OtherBLUE CROSS BLUE SHIELD
TN3811292Medicaid
TN3811292Medicaid
TN3811292Medicaid
TN3147103OtherBLUE CROSS BLUE SHIELD