Dr. Kenneth H. Haller
Family Doctor - Sports Medicine
3600 W Bethel Ave
Muncie
, Indiana 47304-5407
Dr. Kenneth H. Haller
Family Doctor - Sports Medicine
3600 W Bethel Ave
Muncie
, Indiana 47304-5407
(765) 213-3713
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About
Features
Specialties
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Dr. Kenneth H. Haller
- Po Box 1643
- Muncie, IN
- Zip : 47308-1643
- Fax : (765) 213-3713
- Phone : (765) 284-7738
Second Address
- Dr. Kenneth H. Haller
- 3600 W Bethel Ave
- Muncie, IN
- Zip : 47304-5407
- Fax : (765) 213-3713
- Phone : (765) 284-7738
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QS0010X | Family Doctor - Sports Medicine | 02001656A | IN |
National Provider Identifier
| NPI | 1295741197 |
|---|---|
| Provider Name | Dr. Kenneth H. Haller |
| First Address | Muncie, IN 47308-1643 |
| Second Address | Muncie, IN 47304-5407 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 31/07/2006 |
| Last Update Date | 22/01/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000000087018 | ANTHEM PIN (01) | IN |
| 200064610 | (05) | IN |
| 250009136 | RAILROAD MEDICARE (01) | IN |
| F98135 | (02) | IN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.