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Individual

JON ROGER HALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
755 S TELSHOR BLVD, STE 101C, LAS CRUCES, NM 88011-4644
(575) 522-3393
Mailing address
755 S TELSHOR BLVD, STE 101C, LAS CRUCES, NM 88011-4644
(575) 522-3393

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
2001-205
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
32605
CIGNA/LOVELACE
01
NM009780
BLUE CROSS/BLUE SHEILD
NM
Enumeration date
05/31/2005
Last updated
04/24/2008
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