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NPI Code Detail

MEDICARE: GARLINGTON HALLER VENTURES, LLC

MEDICARE: GARLINGTON HALLER VENTURES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1821958810
Entity Type Code : Organization
Provider Name (Legal Business Name) : GARLINGTON HALLER VENTURES, LLC
Provider Business Mailing Address
First Line : PO BOX 8700
Second Line :
City : GULFPORT
State : MS
Zip : 39506-8700
Country : US
Telephone Number : 228-324-1262
Fax Number : 228-273-8922
Provider Business Practice Location Address
First Line : 3565 N MOUNT JULIET RD
Second Line :
City : MT JULIET
State : TN
Zip : 37122-3047
Country : US
Telephone Number : 615-773-9623
Fax Number :
Authorized Official
Title or Position : CEO
Name : TIMOTHY H HALLER
Credential :
Telephone Number : 228-324-1262
Provider Enumeration Date : 11/13/2025
Last Update Date : 11/13/2025

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Directions to “GARLINGTON HALLER VENTURES, LLC ” Practice Location

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