Provider Demographics
NPI:1952358707
Name:HUGH HALL, PSC
Entity Type:Organization
Organization Name:HUGH HALL, PSC
Other - Org Name:HUGH HALL, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:502-349-1212
Mailing Address - Street 1:703 MCDOWELL BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-2651
Mailing Address - Country:US
Mailing Address - Phone:502-349-1212
Mailing Address - Fax:
Practice Address - Street 1:703 MCDOWELL BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-2651
Practice Address - Country:US
Practice Address - Phone:502-349-1212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY26930207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000050161OtherANTHEM
KY1055781OtherPASSPORT
KY64269301Medicaid
KY726778OtherHUMANA
KY64269301Medicaid
E14151Medicare UPIN