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General NPI Number Information
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NPI Number | 1144376393
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Entity Type | Individual
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Provider Name | RYAN CHALONER WINTON HALL M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/28/2007
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Last Update Date | 07/03/2008
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Provider Practice Location Address
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Address Line | 2500 W LAKE MARY BLVD STE 219
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City | LAKE MARY
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State | FL
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Zip | 32746-3501
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Country | US
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Telephone | 407-322-8199
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Fax | 407-322-8169
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Provider Business Mailing Address
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Address Line | 2500 W LAKE MARY BLVD STE 219
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City | LAKE MARY
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State | FL
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Zip | 32746-3501
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Country | US
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Telephone | 407-322-8199
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Fax | 407-322-8169
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | D0062746
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME99792
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License Number State | FL
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