Provider Demographics
NPI:1699734798
Name:HALFORD, WILLIAM DANIEL (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DANIEL
Last Name:HALFORD
Suffix:
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:PO BOX 501123
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-0001
Mailing Address - Country:US
Mailing Address - Phone:615-284-8740
Mailing Address - Fax:
Practice Address - Street 1:7105 S SPRINGS DR
Practice Address - Street 2:STE. 111
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-1710
Practice Address - Country:US
Practice Address - Phone:615-284-1450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2012-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17204207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4064455OtherAETNA
TN3021496Medicare ID - Type Unspecified
TN30214962Medicare PIN
TN4064455OtherAETNA