Provider Demographics
NPI:1457554743
Name:HALE, GARRON RONALD (MD)
Entity Type:Individual
Prefix:
First Name:GARRON
Middle Name:RONALD
Last Name:HALE
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 1:9070 E DESERT COVE DR
Mailing Address - Street 2:#A-103
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6227
Mailing Address - Country:US
Mailing Address - Phone:480-946-4774
Mailing Address - Fax:
Practice Address - Street 1:9070 E DESERT COVE DR
Practice Address - Street 2:#A-103
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6227
Practice Address - Country:US
Practice Address - Phone:480-946-4774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6164207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ260878Medicaid
AZ260878Medicaid