Provider Demographics
NPI:1467535286
Name:HAUSER, GREG ALAN (DC, FICPA)
Entity Type:Individual
Prefix:DR
First Name:GREG
Middle Name:ALAN
Last Name:HAUSER
Suffix:
Gender:M
Credentials:DC, FICPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15810 S 45TH ST
Mailing Address - Street 2:SUITE 160
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-7694
Mailing Address - Country:US
Mailing Address - Phone:480-704-6600
Mailing Address - Fax:480-704-6617
Practice Address - Street 1:15810 S 45TH ST
Practice Address - Street 2:SUITE 160
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-7694
Practice Address - Country:US
Practice Address - Phone:480-704-6600
Practice Address - Fax:480-704-6617
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7290111N00000X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ71737Medicare PIN
AZU92460Medicare UPIN