Hall, Edwin Bacon
Hall, Edwin Bacon is an sole proprietor health care provider with primary practice located at 1709 Girard Blvd Ne , Albuquerque NM 87106-1718. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Hall, Edwin Bacon can be contacted via phone (505) 268-4588.Contact Information
Primary practice address
1709 Girard Blvd Ne
Albuquerque NM 87106-1718
Phone: (505) 268-4588
Fax: (505) 262-2778
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | NM75161 | New Mexico |
Profile Details
| NPI number | 1871557678 |
|---|---|
| LBN Legal business name | Hall, Edwin Bacon |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 17th, 2006 |
| Last updated | Jul 9th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871557678 | NPPES |
| New Mexico | MEDICAID | NM100071 |
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