Individual
JEFFREY HALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 W KENT AVE, MISSOULA, MT 59801-6772
(406) 541-3277
(406) 541-3950
Mailing address
PO BOX 4907, MISSOULA, MT 59806-4907
(406) 541-3277
(406) 541-3950
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
9810
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003084200
—
ID
05
—
120178600
—
WY
05
—
35711
—
MT
Enumeration date
10/03/2005
Last updated
07/10/2024
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