Individual
LISA RENEE HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3085 LAKECREST CIR, LEXINGTON, KY 40513-1707
(859) 258-8600
(859) 258-8610
Mailing address
3085 LAKECREST CIR, LEXINGTON, KY 40513-1707
(859) 258-8600
(859) 258-8610
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35217
KY
208000000X
Pediatrics Physician
35217
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110223769
RR MEDICARE PIN
GA
01
—
37903705
MEDICIAD LAB GRP
KY
01
—
4000501
MEDICARE LAB GRP
KY
05
—
64000912
—
KY
01
—
CB5773
RR MEDICARE GRP
GA
Enumeration date
07/11/2006
Last updated
06/13/2016
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