Provider Demographics
NPI:1477558484
Name:HAEHL, WILLIAM (MD)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:HAEHL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1626 E ST RD 44
Mailing Address - Street 2:SUITE A
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-4057
Mailing Address - Country:US
Mailing Address - Phone:317-421-2012
Mailing Address - Fax:317-421-2016
Practice Address - Street 1:30 W RAMPART ST
Practice Address - Street 2:SUITE 210
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-8877
Practice Address - Country:US
Practice Address - Phone:317-398-0121
Practice Address - Fax:317-398-2335
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2014-01-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01026248A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100317720AMedicaid
IN100317720AMedicaid
IN741720AMedicare PIN