Provider Demographics
NPI:1437194438
Name:HALLER, WILLIAM N III (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:N
Last Name:HALLER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MEDICAL CENTER DR.
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903-1130
Mailing Address - Country:US
Mailing Address - Phone:256-492-8590
Mailing Address - Fax:256-492-4498
Practice Address - Street 1:100 MEDICAL CENTER DR.
Practice Address - Street 2:SUITE 101
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1130
Practice Address - Country:US
Practice Address - Phone:256-492-8590
Practice Address - Fax:256-492-4498
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20053207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009993800Medicaid
AL51509623OtherBCBS AL
AL9993800Medicaid
G36646Medicare UPIN
051509623Medicare ID - Type Unspecified
AL9993800Medicaid