Individual
DR. JOHN CHARLES HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4400 BROADWAY BLVD STE 316, KANSAS CITY, MO 64111-3305
(816) 561-7783
(816) 561-7968
Mailing address
4400 BROADWAY BLVD STE 316, KANSAS CITY, MO 64111-3305
(816) 561-7783
(816) 561-7968
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
R6868
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06573011
BLUE CROSS BLUE SHIELD MO
MO
05
—
100185650A
—
KS
05
—
200429900
—
MO
01
—
39420
BCBS OF KANSAS
KS
01
—
R6868
MO STATE ID #
MO
Enumeration date
06/17/2005
Last updated
09/12/2022
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