Provider Demographics
NPI:1366454332
Name:HAAS, DAVID WILLIAM (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WILLIAM
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 1:1403 S. FEDERAL AVE.
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401
Mailing Address - Country:US
Mailing Address - Phone:641-424-6531
Mailing Address - Fax:641-424-6532
Practice Address - Street 1:1403 S. FEDERAL AVE.
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401
Practice Address - Country:US
Practice Address - Phone:641-424-6531
Practice Address - Fax:641-424-6532
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06802111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0482919Medicaid
IAI16577Medicare PIN
IA0482919Medicaid