Individual
JOHN R HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
321 W PROMENADE ST, MEXICO, MO 65265-2719
(573) 582-1234
(573) 582-1212
Mailing address
321 W PROMENADE ST, MEXICO, MO 65265-2719
(573) 582-1234
(573) 582-1212
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
110843
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203970900
—
MO
Enumeration date
06/23/2005
Last updated
08/23/2022
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