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General NPI Number Information
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NPI Number | 1861493249
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Entity Type | Individual
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Provider Name | PENELOPE ANN HALLIDAY MD
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Gender | Female
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 10/09/2012
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Provider Practice Location Address
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Address Line | 403 E MARKET ST
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City | WASHINGTON CH
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State | OH
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Zip | 43160-1433
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Country | US
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Telephone | 740-335-0741
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Fax | 740-335-9473
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Provider Business Mailing Address
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Address Line | 403 E MARKET ST
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City | WASHINGTON CH
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State | OH
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Zip | 43160-1433
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Country | US
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Telephone | 740-335-0741
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Fax | 740-335-9473
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35-04-5762
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License Number State | OH
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