Individual
JONATHAN ROBERTS HALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DSC, PA-C
Contact information
Practice address
2817 ROCK MERRITT AVE, FORT BRAGG, NC 28310-0001
(910) 907-8922
Mailing address
2817 ROCK MERRITT AVE, FORT BRAGG, NC 28310-0001
(910) 907-8922
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
61085816
WA
Other
Enumeration date
03/08/2011
Last updated
11/04/2025
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