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Individual

BRUCE A HALL

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2200 E SHOW LOW LAKE RD, SHOW LOW, AZ 85901-7881
(928) 537-4375
Mailing address
300 W WHITE MOUNTAIN BLVD, STE D, LAKESIDE, AZ 85929-7014
(928) 368-4547
(928) 368-4527

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25444
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
405820
AZ
Enumeration date
12/28/2005
Last updated
04/19/2017
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