Doctor Name: | MR. JASON STEWART HALLER |
NPI Number: | 1649604349 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | EMT-B |
License Number: | E1726952 |
Business Practice Address: | Bld 301 Andrews Ave Lyster Army Health Clinic Ft. Rucker, AL - 363625333 |
Business Phone Number: | 3342557636 |
Business Fax Number: | 3342557368 |
Mailing Address: | Bld 301 Andrews Ave, Lyster Army Health Clinic FT. RUCKER |
State: | AL |
Postal Code: | 363625333 |
Phone Number: | 3342557636 |
Fax Number: | 3342557368 |
NPI Enumeration Date: | 08/29/2013 |
NPI Last Update Date: | 08/29/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 146N00000X |
License Number: | E1726952 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Emergency Medical Service Providers |
Taxonomy Classification: | Emergency Medical Technician, Basic |
Taxonomy Specialization: | |
Taxonomy Definition: | A Basic EMT is an individual trained and certified to perform basic life support treatment in medical emergencies based on individual state boards. |