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Individual

ELISABETH JONES HALLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1721 MEDICAL PARK DR STE 200, BILOXI, MS 39532-2105
(228) 248-2572
(228) 396-0687
Mailing address
PO BOX 8873, BILOXI, MS 39535-8873
(228) 248-2572
(228) 396-0687

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
15807
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00120595
MS
Enumeration date
09/15/2006
Last updated
07/08/2007
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