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General NPI Number Information
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NPI Number | 1912354853
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Entity Type | Individual
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Provider Name | MATTHEW HALTOM M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/20/2016
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 5050 POPLAR AVE STE 800
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City | MEMPHIS
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State | TN
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Zip | 38157-0800
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Country | US
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Telephone | 901-276-2662
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Fax | 901-274-2033
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Provider Business Mailing Address
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Address Line | 5050 POPLAR AVE STE 800
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City | MEMPHIS
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State | TN
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Zip | 38157-0800
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Country | US
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Telephone | 901-276-2662
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Fax | 901-274-2033
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 60449
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 60449
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 60449
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License Number State | TN
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