LUKE TYLER HALL (NPI# 1417150376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417150376 |
| Entity Type | Individual |
| Full Name | LUKE TYLER HALL |
| Credential | M.D. |
| Practice Address |
1407 Locust St Eldorado IL 62930 |
| Mailing Address |
1201 Pine St Eldorado IL 62930-1634 |
| Practice Telephone | 6182733361 |
| Mailing Telephone | 3145316351 |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2018-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036128470 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036128470 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740800150 | Luke M Hall | Student in an Organized Health Care Education/Training Program | 208 Medical Park Blvd, Bristol, TN 37620-7343 | 2020-04-26 |
| Street Address |
1407 LOCUST ST |
| City | ELDORADO |
| State | IL |
| Zip Code | 62930 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063885101 | Susan E Sigler | Nurse Practitioner | 1407 Locust St, Eldorado, IL 62930-1629 | 2015-11-12 |
| 1760625669 | Ferrell Hospital Community Foundation | Physician Assistant | 1407 Locust St, Eldorado, IL 62930-1629 | 2009-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164951802 | Jeanette Long X | Licensed Practical Nurse | 70 Alexander St, Eldorado, IL 62930 | 2017-06-07 |
| 1720510514 | Mckayla Addison Wren | Counselor | 1412 Us. 45n, Eldorado, IL 62930 | 2017-03-30 |
| 1407394901 | Melody Jo Smith | Licensed Practical Nurse | 2260 Raleigh Road, Eldorado, IL 62930 | 2017-02-03 |
| 1205250412 | Becks Long Term Care Pharmacy Inc | Pharmacy | 1413 Locust Street, Eldorado, IL 62930 | 2014-02-07 |
| 1346559283 | Danny Ray Phillips | Pharmacist | 1021 Us Hwy 45 North, Eldorado, IL 62930 | 2010-09-27 |
| 1447434477 | Elana Ruth Floyd-kennett | Social Worker | 1007 Route 45, Eldorado, IL 62930 | 2007-12-27 |
| 1134320039 | Eldorado Community Unit School District #4 | Local Education Agency (LEA) | 1040 Washington, Eldorado, IL 62930 | 2007-05-29 |
| 1013071026 | Marion Eye Centers Ltd. | Durable Medical Equipment & Medical Supplies | 1204 U.S. 45 N., Eldorado, IL 62930 | 2006-12-21 |
| 1467536557 | Debra Dian Rumsey | Licensed Practical Nurse | 607 4th Street, Eldorado Rural Health Clinic, Eldorado, IL 62930 | 2006-10-25 |
| 1902989429 | Barbara L Kreps | Licensed Practical Nurse | 6007 4th Street, Eldorado Rural Health Clinic, Eldorado, IL 62930 | 2006-10-21 |
| Find all providers in zip 62930 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528274107 | Jim Bob Brame | Family Medicine | 1973 Bell Lane, Eldorado, TX 77693-1249 | 2007-05-14 |
| 1457405136 | Preferred Hospital Leasing Eldorado, Inc. | Family Medicine | 102 N Us Highway 277, Eldorado, TX 76936 | 2007-01-22 |
| 1679540686 | Med Contract Inc | Family Medicine | 911 4th St, Eldorado, IL 62930-1203 | 2006-03-08 |
| 1902886583 | Christopher Greater Area Rural Health Planning Corp | Family Medicine | 1306 Maple St, Doctors Clinic, Eldorado, IL 62930 | 2006-01-19 |
| 1750716262 | Peterson Family Medicine | Family Medicine | 911 4th St, Eldorado, IL 62930-1203 | 2013-09-04 |
| 1912269903 | Joseph Jackson | Family Medicine | 1300 Us Highway 45 N, Eldorado, IL 62930 | 2012-06-14 |
| 1366753691 | Albert G Bledig Md Chartered | Family Medicine | 1405 Locust St, Eldorado, IL 62930-1629 | 2010-07-01 |
| 1801076146 | Michael Anthony Blain | Family Medicine | 607 4th St, Eldorado, IL 62930-1278 | 2007-11-04 |
| 1780883843 | Nathan Oldham | Family Medicine | 1201 Pine St, Eldorado, IL 62930-1634 | 2007-07-17 |
| 1699873117 | Craig V Svoboda | Family Medicine | 607 4th St, Eldorado Rural Health Clinic, Eldorado, IL 62930 | 2006-09-20 |
| Find all providers in ELDORADO | ||||
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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.