Healthcare Provider Details

I. General information

NPI: 1063431823
Provider Name (Legal Business Name): DEBORAH M. HALL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBORAH M. CHRISTIE M.D.

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 08/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 SHAWNEE MISSION PKWY SUITE 2201
WESTWOOD KS
66205-2005
US

IV. Provider business mailing address

2330 SHAWNEE MISSION PKWY SUITE 2201
WESTWOOD KS
66205-2005
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-9800
  • Fax: 913-588-9803
Mailing address:
  • Phone: 913-588-9800
  • Fax: 913-588-9803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number100663
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number04-25013
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: