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General NPI Number Information
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NPI Number | 1326243544
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Entity Type | Individual
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Provider Name | JEFFREY HALLADAY M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 4646 JOHN R ST
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City | DETROIT
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State | MI
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Zip | 48201-1916
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Country | US
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Telephone | 313-576-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 601 JOHN ST STE M-124
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City | KALAMAZOO
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State | MI
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Zip | 49007-5341
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Country | US
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Telephone | 269-341-7500
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Fax | 269-341-7540
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 0450009
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 40163
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 4301099265
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License Number State | MI
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