Provider Demographics
NPI:1215932397
Name:HALL, CHRISTOPHER JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JAMES
Last Name:HALL
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 1:5625 POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-3816
Mailing Address - Country:US
Mailing Address - Phone:901-761-1220
Mailing Address - Fax:901-763-4332
Practice Address - Street 1:5625 POPLAR AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-3816
Practice Address - Country:US
Practice Address - Phone:901-761-1220
Practice Address - Fax:901-763-4332
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38419207Y00000X
ARE4088207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4087704OtherTN BLUE CROSS
5938331OtherCIGNA
AR5M925OtherBLUE CROSS AR
5938331OtherCIGNA
TN3895265Medicare ID - Type UnspecifiedMEDICARE
TNI13272Medicare UPIN
AR3895265Medicare ID - Type UnspecifiedARKANSAS MEDICARE