Provider Demographics
NPI:1952521007
Name:HALL, STEPHANIE Z (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:Z
Last Name:HALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:LYNN
Other - Last Name:ZOELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 W MUHAMMAD ALI BLVD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1423
Mailing Address - Country:US
Mailing Address - Phone:502-589-8600
Mailing Address - Fax:
Practice Address - Street 1:4710 CHAMPIONS TRACE LN
Practice Address - Street 2:# 102
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-3495
Practice Address - Country:US
Practice Address - Phone:502-736-3051
Practice Address - Fax:502-736-3052
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01054996A2084P0800X
KY348932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry