# COREY HALL MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902126907
- **Authorized official:** MR. COREY M HALL MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (225) 678-5316

## Contact information

- **Practice address:** 606 COLONIAL DR, SUITE A, BATON ROUGE, LA 70806-6535
- **Practice address phone:** (225) 678-5316
- **Practice address fax:** (225) 927-6399
- **Mailing address:** 606 COLONIAL DR, BATON ROUGE, LA 70806-6535
- **Mailing address phone:** (225) 678-5316
- **Mailing address fax:** (225) 927-6399

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 14754R | LA | Yes |

## Other

- **Enumeration date:** 06/02/2010
- **Last updated:** 06/02/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1140651 | — | LA |