Provider Demographics
NPI:1457355059
Name:HALE, BRIAN D (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:D
Last Name:HALE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12109 COUNTY ROAD 103
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:FL
Mailing Address - Zip Code:34484-2951
Mailing Address - Country:US
Mailing Address - Phone:352-205-8981
Mailing Address - Fax:352-391-6498
Practice Address - Street 1:35095 US HIGHWAY 19 N
Practice Address - Street 2:STE 202
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-1971
Practice Address - Country:US
Practice Address - Phone:727-771-0600
Practice Address - Fax:727-781-9666
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2021-02-02
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Provider Licenses
StateLicense IDTaxonomies
FLME67771208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG06491Medicare UPIN