Individual
GRAHAM CHARLES HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1072 N LIBERTY ST STE 200, BOISE, ID 83704-8963
(208) 302-4100
(208) 302-4135
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
01080885A
IN
207T00000X
Neurological Surgery Physician
Primary
M-15928
ID
208600000X
Surgery Physician
47390
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300018084
—
IN
05
—
7100142170
—
KY
Enumeration date
06/25/2009
Last updated
07/18/2023
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