Individual
ADAM D HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7601 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
(260) 436-8686
(260) 436-8585
Mailing address
PO BOX 2526, FORT WAYNE, IN 46801-2526
(260) 436-8686
(260) 436-8585
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01066989A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000876126
ANTHEM
IN
05
—
201232330
—
IN
01
—
P01479925
RAILROAD MEDICARE
—
Enumeration date
10/09/2008
Last updated
11/03/2016
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