Individual
HAROLD DALE HALLER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4003 KRESGE WAY STE 312, LOUISVILLE, KY 40207-4652
(502) 899-7377
(502) 899-1972
Mailing address
4003 KRESGE WAY, STE 312, LOUISVILLE, KY 40207
(502) 899-7377
(502) 899-1972
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
31062
KY
207RP1001X
Pulmonary Disease Physician
Primary
31062
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1079140
PASSPORT
KY
01
—
290012790
RR MEDICARE
KY
05
—
64310626
—
KY
Enumeration date
02/16/2006
Last updated
03/05/2024
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