Organization
RANDALL E HALLEY DO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYLE L KLIPPER (MANAGER)
(417) 753-9404
Entity
Organization
Contact information
Practice address
1200 W HALL ST, OZARK, MO 65721-9103
(417) 753-9404
Mailing address
PO BOX 1455, OZARK, MO 65721-1455
(417) 753-9404
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
R9D75
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
505984203
—
MO
Enumeration date
04/18/2007
Last updated
07/22/2011
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