Provider Demographics
NPI:1205808474
Name:ARTHUR L HALL MD PA
Entity type:Organization
Organization Name:ARTHUR L HALL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:L
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-645-5774
Mailing Address - Street 1:149 EDINBURGH DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-4102
Mailing Address - Country:US
Mailing Address - Phone:407-645-5774
Mailing Address - Fax:407-645-3464
Practice Address - Street 1:149 EDINBURGH DR
Practice Address - Street 2:SUITE A
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-4102
Practice Address - Country:US
Practice Address - Phone:407-645-5774
Practice Address - Fax:407-645-3464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-02
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0045648207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL39397Medicare ID - Type UnspecifiedMEDICARE GROUP #