Individual provider · Type 1 NPI

Jonathan Roberts Haller, DSC, PA-C

Surgical Physician Assistant · Fort Bragg, NC

NPI number 1164720686 Active

Practice location

2817 Rock Merritt Ave
Fort Bragg, NC 28310-0001

Call (910) 907-8922 Map

Other practice locations

  • 9040 Jackson Ave, Tacoma, WA 98431-0001 · (253) 968-3885

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700XNone listed
Physician Assistant 363A00000XNone listed
Surgical Physician Assistant Primary 363AS0400X61085816 (WA)

Surgical Physician Assistant: Definition to come...

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About NPI 1164720686

Jonathan Roberts Haller, DSC, PA-C's National Provider Identifier is 1164720686, issued on Mar 8, 2011. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Fort Bragg, NC. The record was last updated on Nov 4, 2025.