MEDICARE: MR. WILLIAM RILEY HALL PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	23641	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437696986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM RILEY HALL PMHNP-BC

Provider Business Mailing Address
First Line	:	1122 LADY ST OFC 229
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201-3489
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1122 LADY ST OFC 229
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201-3489
Country	:	US
Telephone Number	:	803-998-2581
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2017
Last Update Date	:	08/15/2023

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