Basic Information
Provider Information
NPI: 1477972610
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HALE
FirstName: DANIEL
MiddleName: ALAN
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9705 LENEXA DR
Address2:  
City: LENEXA
State: KS
PostalCode: 662151345
CountryCode: US
TelephoneNumber: 8162413338
FaxNumber: 8169368118
Practice Location
Address1: 9705 LENEXA DR
Address2:  
City: LENEXA
State: KS
PostalCode: 662151345
CountryCode: US
TelephoneNumber: 8162413338
FaxNumber: 8169368118
Other Information
ProviderEnumerationDate: 04/15/2014
LastUpdateDate: 05/28/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZH0000X04-42115KSN Allopathic & Osteopathic PhysiciansPathologyHematology
207ZP0102X04-42115KSY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

No ID Information.


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