MEDICARE: DR. KATHRYN ANNE HALL D.O.

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	208D00000X	General Practice Physician	2952	OK

General Provider Information

NPI Number	:	1376742148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHRYN ANNE HALL D.O.

Provider Business Mailing Address
First Line	:	13301 N MERIDIAN AVE STE 400
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-8357
Country	:	US
Telephone Number	:	405-755-4600
Fax Number	:	405-755-4837

Provider Business Practice Location Address
First Line	:	13301 N MERIDIAN AVE STE
Second Line	:	400
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-8357
Country	:	US
Telephone Number	:	405-755-4600
Fax Number	:	405-755-4837

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

Provider Enumeration Date	:	07/12/2007
Last Update Date	:	07/12/2007

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