Individual
JUSTIN M HALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
590 WAKARA WAY, SALT LAKE CITY, UT 84108
(801) 587-5457
(801) 587-7111
Mailing address
50 NORTH MEDICAL DRIVE, SALT LAKE CITY, UT 84132
(801) 587-5457
(801) 587-7111
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
8153449-1205
UT
207XX0801X
Orthopaedic Trauma Physician
Primary
8153449-8905
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790009264
—
WA
Enumeration date
03/26/2010
Last updated
05/28/2025
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