Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | ME45648 | FL |
N | 207QG0300X | Family Doctor - Geriatric Medicine | ME45648 | FL |
NPI | 1093717613 |
---|---|
Provider Name | Arthur L. Hall |
First Address | Longwood, FL 32750 |
Second Address | Orlando, FL 32817 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2005 |
Last Update Date | 29/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
05545 | BCBS (01) | FL |
101851 | AVMED ID # (01) | FL |
256255300 | (05) | FL |
274935100 | (05) | FL |
D45532 | (02) | FL |