Provider Demographics
NPI:1225047392
Name:HALL, WENDELL LEE (PA)
Entity Type:Individual
Prefix:MR
First Name:WENDELL
Middle Name:LEE
Last Name:HALL
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:9521 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-1547
Mailing Address - Country:US
Mailing Address - Phone:913-381-3102
Mailing Address - Fax:
Practice Address - Street 1:4801 E LINWOOD BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64128-2226
Practice Address - Country:US
Practice Address - Phone:816-861-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant