| Doctor Name: | MR. JOHN TIM HASKETT |
| NPI Number: | 1659405728 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | G.N.P. |
| License Number: | 6064 |
| Business Practice Address: | 4410 Chaffin Rd Mckinleyville, CA - 955198029 |
| Business Phone Number: | 7078452570 |
| Business Fax Number: | 8889609819 |
| Mailing Address: | Po Box 6860, EUREKA |
| State: | CA |
| Postal Code: | 955026860 |
| Phone Number: | 7074433384 |
| Fax Number: | 7074433204 |
| NPI Enumeration Date: | 03/14/2007 |
| NPI Last Update Date: | 11/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | 6064 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |