Provider Demographics
NPI:1144223561
Name:HAAS, WILLIAM M (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:M
Last Name:HAAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13260 N 94TH DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4240
Mailing Address - Country:US
Mailing Address - Phone:623-583-6570
Mailing Address - Fax:623-583-6571
Practice Address - Street 1:13260 N 94TH DR
Practice Address - Street 2:SUITE 205
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4240
Practice Address - Country:US
Practice Address - Phone:623-583-6570
Practice Address - Fax:623-583-6571
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7394111N00000X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0939450OtherBCBS ID
AZZ103320OtherMEDICARE ID-PIN
AZZ103320OtherMEDICARE ID-PIN
AZZ103320Medicare PIN