MEDICARE: DR. THOMAS H HALE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD36168	MO

General Provider Information

NPI Number	:	1225009905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS H HALE MD

Provider Business Mailing Address
First Line	:	2200 BARRETT STATION RD
Second Line	:
City	:	MANCHESTER
State	:	MO
Zip	:	63021-3824
Country	:	US
Telephone Number	:	314-821-1313
Fax Number	:

Provider Business Practice Location Address
First Line	:	2200 BARRETT STATION RD
Second Line	:
City	:	MANCHESTER
State	:	MO
Zip	:	63021-3824
Country	:	US
Telephone Number	:	314-821-1313
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	07/08/2007

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