PHILLIP K. HALL (NPI# 1144248493) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144248493 |
| Entity Type | Individual |
| Full Name | PHILLIP K. HALL |
| Credential | M.D. |
| Practice Address |
5300 Far Hills Ave. Dayton OH 45429-2347 |
| Mailing Address |
10727 Falls Creek Ln Centerville OH 45458-6063 |
| Practice Telephone | 9374337536 |
| Practice Fax Number | 9374339612 |
| Mailing Telephone | 9378854310 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2016-08-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
35070320H | OH | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
35070320H | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | ANTHEM BLUE SHIELD | 3109647743A18 | 01 |
| OH | UNITED HEALTH CARE | 0300288 | 01 |
| OH | AETNA | 0649150 | 01 |
| OH | NATIONWIDE | OC02792 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972943785 | Phillip Bradley Hall | Family Medicine | 680 Genesis Blvd, Ste 201, Bridgeport, WV 26330-9135 | 2013-06-26 |
| 1982643623 | Phillip Clark Hall | Dentist | 335 E Saint George Blvd Ste 201, Saint George, UT 84770-7106 | 2006-06-06 |
| 1003385675 | Phillip Alexander Hall | Case Manager/Care Coordinator | 847 Ne 19th Ave Ste 100, Portland, OR 97232-2684 | 2018-11-13 |
| 1760542831 | Phillip M Hall | Internal Medicine | 9500 Euclid Ave, Cleveland, OH 44195-0001 | 2006-12-11 |
| Street Address |
5300 FAR HILLS AVE. |
| City | DAYTON |
| State | OH |
| Zip Code | 45429-2347 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801814272 | Rafael A. Perez-figaredo | Dermatology | 5300 Far Hills Ave., Dayton, OH 45429-2347 | 2006-07-17 |
| 1861587115 | Matthew Aaron Bakos | Dermatology | 5300 Far Hills Ave., Dayton, OH 45429-2347 | 2006-10-03 |
| 1558381806 | Robert A Palacio | Dermatology | 5300 Far Hills Ave., Dayton, OH 45429-2347 | 2006-07-20 |
| 1639197049 | Mark E. Fenster | Dermatology | 5300 Far Hills Ave., Dayton, OH 45429-2347 | 2006-07-17 |
| 1871511188 | John C. Lepage | Dermatology | 5300 Far Hills Ave., Dayton, OH 45429-2347 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821576414 | Lauren Danielle Sivley | Nurse Practitioner | 3535 Sourthern Boulevard, Kettering, OH 45429 | 2018-08-06 |
| 1114446127 | Louai Al-samkari | Chiropractor | 1441 E. Stroop Rd., Kettering, OH 45429 | 2017-09-12 |
| 1407373756 | Benjamin Edward Adkins | Specialist/Technologist | 4116 Vinita Dr., Kettering, OH 45429 | 2017-08-28 |
| 1972036341 | James Kim | Student in an Organized Health Care Education/Training Program | 3535 Southern Boulevard, Kettering, OH 45429 | 2017-04-04 |
| 1023549847 | Adrienne Krysiak | Emergency Medicine | 3525 Southern Boulevard, Kettering, OH 45429 | 2017-03-23 |
| 1386021889 | Cassandra Mckoy | Counselor | 529 East Stroop Road, Kettering, OH 45429 | 2015-05-04 |
| 1417343088 | Candace Benoit | Obstetrics & Gynecology | 3533 Southern Blvd Ste 4600, Dayton, OH 45429 | 2015-04-10 |
| 1275933574 | Lee Schwieterman | Nurse Practitioner | 3535 Southern Blvd., 1 East, Kettering, OH 45429 | 2014-08-25 |
| 1497161947 | Robert Jonathon Fresch Jr. | Obstetrics & Gynecology | 3533 Southern Blvd Ste 3750, Kettering, OH 45429 | 2014-07-05 |
| 1821349812 | Lucas Brewer | Counselor | 1524 E Stroop Rd Ste 300, Kettering, OH 45429 | 2012-10-01 |
| Find all providers in zip 45429 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891783494 | Henry Michael Duke | Dermatology | 6210 N Main St, Dayton, OH 45415-3111 | 2005-10-10 |
| 1639197049 | Mark E. Fenster | Dermatology | 5300 Far Hills Ave., Dayton, OH 45429-2347 | 2006-07-17 |
| 1861449274 | Heidi B Donnelly | Dermatology | 3025 Governors Place Blvd, Dayton, OH 45409-1330 | 2006-05-30 |
| 1710932454 | Dayton Skin Surgery Center Inc | Dermatology | 3025 Governors Place Blvd, Dayton, OH 45409-1330 | 2006-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689973638 | Apex Dermatology and Skin Surgery Center LLC | Dermatology | 7580 Auburn Road, Suite 301, Tripoint Medical Center, Physician Pavillion, Painesville, OH 44077 | 2011-03-16 |
| 1235442211 | Dermatology & Surgery of Southern Ohio, Inc. | Dermatology | 7132 Cincinnati Dayton Rd, Suite 200, Liberty Townshp, OH 45069-1775 | 2010-07-20 |
| 1619070224 | West Ohio Dermatology, Inc. | Dermatology | 750 W High St Ste 300, Lima, OH 45801-2967 | 2006-09-07 |
| 1912910803 | Harry Michael Humeniuk | Dermatology | 4935 Harroun Rd, Sylvania, OH 43560-2107 | 2006-08-14 |
| 1952307324 | Jennifer L Popovsky | Dermatology | 1133 Medina Rd Ste 100, Medina, OH 44256-5913 | 2005-06-21 |
| 1356884837 | Bravia Dermatology Group, LLC | Dermatology | 2000 Regency Ct, Suite #201, Toledo, OH 43623-3090 | 2016-12-01 |
| 1932592698 | Allied Dermatology and Skin Surgery, LLC | Dermatology | 3624 W Market St Ste 101, Fairlawn, OH 44333-4510 | 2015-03-05 |
| 1205104601 | Dermatologic Surgery Center of Northeast Ohio Inc | Dermatology | 1133 Medina Rd, Suite 100, Medina, OH 44256-0000 | 2011-12-13 |
| 1508197112 | Ohio Skin Cancer Institute LLC | Dermatology | 602 Morrison Rd, Gahanna, OH 43230-5342 | 2010-01-21 |
| 1942433065 | Columbus Skin Surgery Center, Inc. | Dermatology | 6670 Perimeter Dr, Suite 260, Dublin, OH 43016-8056 | 2009-08-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.