Individual
DR. KENNETH H. HALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3600 W BETHEL AVE, MUNCIE, IN 47304-5407
(765) 284-7738
(765) 213-3713
Mailing address
3600 W BETHEL AVE, MUNCIE, IN 47304-5407
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
02001656A
IN
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
02001656A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000087018
ANTHEM PIN
IN
05
—
200064610
—
IN
01
—
250009136
RAILROAD MEDICARE
IN
Enumeration date
07/31/2006
Last updated
12/11/2025
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