Individual
LESLIE W HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
37695
SC
207R00000X
Internal Medicine Physician
R2J99
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
128011
BLUE SHIELD/BLUE CHOICE
MO
05
—
202512513
—
MO
01
—
394166
HEALTHLINK
MO
01
—
400639
UNITED HEALTHCARE
MO
05
—
732448
—
SC
Enumeration date
06/01/2006
Last updated
04/23/2021
Update your record
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