Provider Demographics
NPI:1275640740
Name:ROBERT & WILLIAM HASS OPTOMETRISTS PROFESSIONAL CORP
Entity Type:Organization
Organization Name:ROBERT & WILLIAM HASS OPTOMETRISTS PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:HASS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:989-845-3835
Mailing Address - Street 1:1180 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:CHESANING
Mailing Address - State:MI
Mailing Address - Zip Code:48616-1006
Mailing Address - Country:US
Mailing Address - Phone:989-845-3835
Mailing Address - Fax:989-845-3982
Practice Address - Street 1:1180 W BROAD ST
Practice Address - Street 2:
Practice Address - City:CHESANING
Practice Address - State:MI
Practice Address - Zip Code:48616-1006
Practice Address - Country:US
Practice Address - Phone:989-845-3835
Practice Address - Fax:989-845-3982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002552152W00000X, 332H00000X
MI4901002808332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0G36400Medicare PIN
MI0284720003Medicare NSC