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General NPI Number Information
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NPI Number | 1881638013
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Entity Type | Individual
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Provider Name | ROBERT L HALTERMAN D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/16/2006
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 1100 E POPLAR ST STE A
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City | CLARKSVILLE
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State | AR
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Zip | 72830-4419
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Country | US
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Telephone | 479-754-5337
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Fax | 479-754-5348
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Provider Business Mailing Address
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Address Line | 901 E. 104TH ST. MAILSTOP 400N
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City | KANSAS CITY
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State | MO
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Zip | 64131-9712
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Country | US
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Telephone | 816-502-8752
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Fax | 816-932-9670
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 119015
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 02241
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 119015
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 200300349
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License Number State | NC
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