Phillip Bradley Hall, M.D.

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

15899 Issued in WV

Practice address

680 Genesis Blvd
Ste 201
Bridgeport, WV 26330-9135

Phone

(304) 933-1030

Fax

(304) 933-1006

NPI assigned

Jun 26, 2013

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1972943785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 GENESIS BLVD",
            "address_2": "STE 201",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309135",
            "telephone_number": "304-933-1030",
            "fax_number": "304-933-1006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 GENESIS BLVD",
            "address_2": "STE 201",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309135",
            "telephone_number": "304-933-1030",
            "fax_number": "304-933-1006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "PHILLIP",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-26",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "WV",
            "license": "15899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Lynn Hackett, CRNA
• Christopher Hagedorn, CRNA
• Juliet Haines, MOT
• Bethany Marie Hall, D.O.
• Lindsey Marie Hall, PA-C
• Tammy Morgan Hamner
• Hanger Prosthetics & Orthotics East, Inc.
• Josie Hanlin
• Adam J Hansen, M.D.
• Erik Joseph Hanson

• Addiction Medicine (Family Medicine) Physician in Bridgeport, WV
• Providers in Bridgeport, WV by specialty
• Addiction Medicine (Family Medicine) Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.