Provider Demographics
NPI:1699739839
Name:HALL, ROY LOUIS (MD)
Entity type:Individual
Prefix:
First Name:ROY
Middle Name:LOUIS
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 1:2884 LENGEL RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45244-3934
Mailing Address - Country:US
Mailing Address - Phone:216-496-8072
Mailing Address - Fax:
Practice Address - Street 1:2884 LENGEL RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45244
Practice Address - Country:US
Practice Address - Phone:216-496-8072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD419975207L00000X
SC18146207L00000X
IN01064444A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G08049Medicare UPIN