Individual
KIM A. HALLADAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
2356 N 400 E, STE 104, TOOELE, UT 84074-3409
(435) 882-0711
(435) 882-1778
Mailing address
2356 N 400 E, STE 104, TOOELE, UT 84074-3409
(435) 882-0711
(435) 882-1778
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
103966-0501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0994190001
DME
UT
01
—
107006704101
IHC
UT
01
—
2649
PEHP
UT
01
—
36338
DMBA
UT
01
—
480008495
RAILROAD MEDICARE
UT
01
—
870406457 84074
TRICARE
UT
01
—
870406457 HA1
EMIA
UT
01
—
QM0000054283
ALTIUS
UT
Enumeration date
05/27/2005
Last updated
12/17/2010
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