MEDICARE: DR. RICHARD R HALL 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	207V00000X	Obstetrics & Gynecology Physician	4301079066	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710950332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD R HALL MD

Provider Business Mailing Address
First Line	:	1607 SHORTHORN ST
Second Line	:
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-4749
Country	:	US
Telephone Number	:	620-275-9752
Fax Number	:	620-275-4306

Provider Business Practice Location Address
First Line	:	1607 SHORTHORN ST
Second Line	:
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-4749
Country	:	US
Telephone Number	:	620-275-9752
Fax Number	:	620-275-4306

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

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	07/08/2007

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