Healthcare Provider Details

I. General information

NPI: 1245226042
Provider Name (Legal Business Name): BILL HALE HALMI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 05/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 E HIGHLAND AVE STE 101
PHOENIX AZ
85014-3649
US

IV. Provider business mailing address

740 E HIGHLAND AVE STE 101
PHOENIX AZ
85014-3649
US

V. Phone/Fax

Practice location:
  • Phone: 602-264-9044
  • Fax: 602-264-0057
Mailing address:
  • Phone: 602-264-9044
  • Fax: 602-264-0057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number22591
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: