JONATHAN ROBERTS HALLER DSC PA-C NPI 1164720686

NPI Information

  • NPI: 1164720686
  • Provider Name: JONATHAN ROBERTS HALLER, DSC, PA-C
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Individual
  • Address: 2817 ROCK MERRITT AVE
    FORT LIBERTY, NC
    ZIP 28310
  • Phone: (910) 907-8922

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NPI Details

Jonathan Roberts Haller, DSC, PA-C is a surgical physician assistant in Fort Liberty, NC. Jonathan Roberts Haller, DSC, PA-C NPI is 1164720686. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2817 ROCK MERRITT AVE
FORT LIBERTY, NC
ZIP 28310-001
Phone: (910) 907-8922

The enumeration date for this NPI number is 3/8/2011 and was last updated on 2/5/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363A00000XPhysician AssistantNo
2363AM0700XPhysician AssistantMedicalNo
3363AS0400XPhysician AssistantSurgical61085816WASHINGTONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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