Provider Demographics
NPI:1215062559
Name:HALE, DAN EUGENE (DO)
Entity type:Individual
Prefix:DR
First Name:DAN
Middle Name:EUGENE
Last Name:HALE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:9123 CROSS PARK DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4552
Mailing Address - Country:US
Mailing Address - Phone:865-670-0039
Mailing Address - Fax:865-670-0127
Practice Address - Street 1:9123 CROSS PARK DR
Practice Address - Street 2:SUITE 200
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4552
Practice Address - Country:US
Practice Address - Phone:865-670-0039
Practice Address - Fax:865-670-0127
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNDO301204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN74217Medicare UPIN