Individual
PHILLIP K. HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5300 FAR HILLS AVE., DAYTON, OH 45429-2347
(937) 433-7536
(937) 433-9612
Mailing address
10727 FALLS CREEK LN, CENTERVILLE, OH 45458-6063
(937) 885-4310
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
35070320H
OH
207NS0135X
Procedural Dermatology Physician
35070320H
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0300288
UNITED HEALTH CARE
OH
01
—
0649150
AETNA
OH
01
—
3109647743A18
ANTHEM BLUE SHIELD
OH
01
—
OC02792
NATIONWIDE
OH
Enumeration date
07/17/2006
Last updated
08/03/2016
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