Provider Demographics
NPI:1447582499
Name:JAMES E. HAUGHN
Entity Type:Organization
Organization Name:JAMES E. HAUGHN
Other - Org Name:WABASH MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:HAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-563-7495
Mailing Address - Street 1:645 N SPRING ST
Mailing Address - Street 2:
Mailing Address - City:WABASH
Mailing Address - State:IN
Mailing Address - Zip Code:46992-1824
Mailing Address - Country:US
Mailing Address - Phone:260-563-7495
Mailing Address - Fax:260-563-7231
Practice Address - Street 1:645 N SPRING ST
Practice Address - Street 2:
Practice Address - City:WABASH
Practice Address - State:IN
Practice Address - Zip Code:46992-1824
Practice Address - Country:US
Practice Address - Phone:260-563-7495
Practice Address - Fax:260-563-7231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-02
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01021600261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
C25929Medicare UPIN