1982782942 NPI number — DR. JOSPEH FRANCIS HAAS M.D., FACS

Table of content: (NPI 1730642216)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982782942 NPI number — DR. JOSPEH FRANCIS HAAS M.D., FACS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAAS
Provider First Name:
JOSPEH
Provider Middle Name:
FRANCIS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D., FACS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982782942
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/02/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
40 N GRAND AVE
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
FORT THOMAS
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41075-4107
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-781-4900
Provider Business Mailing Address Fax Number:
859-572-3044

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
40 N GRAND AVE
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
FORT THOMAS
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41075-4107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-781-4900
Provider Business Practice Location Address Fax Number:
859-572-3044
Provider Enumeration Date:
11/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Y00000X , with the licence number:  18612 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207YP0228X , with the licence number: 18612 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207YX0602X , with the licence number: 18612 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207YX0901X , with the licence number: 18612 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 701342 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 35-036515 . This is a "OH MEDICAL LICENSE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 200209450 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4026241 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 701324 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 18612 . This is a "KY MEDICAL LICENSE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000033976 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10-20162 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100015770 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1046375 . This is a "IN MEDICAL LICENSE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 1090 . This is a "CHA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 64186125 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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