Individual
TIFFANY HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3725 CHAMPION HILLS DR STE 2000, MEMPHIS, TN 38125-0502
(901) 367-9001
(901) 565-8787
Mailing address
PO BOX 1000, DEPT 362, MEMPHIS, TN 38148-0362
(901) 367-9001
(901) 255-5223
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36781
TN
208000000X
Pediatrics Physician
36781
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04735812
—
MS
05
—
107001001
—
AR
01
—
4108593
BCBS
TN
01
—
99182
BCBS
AR
Enumeration date
07/12/2006
Last updated
10/14/2014
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