Organization Name: | S. W. HAAG, P.C. |
NPI Number: | 1811108889 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STANLEY WILLARD HAAG (OWNER) |
Mailing Address: | 507 Maple St Chetopa |
State: | KS US |
Postal Code: | 673369192 |
Phone Number: | 6202367322 |
Fax Number: | 6202367323 |
NPI Enumeration Date: | 05/24/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 0425012 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |