Provider Demographics
NPI:1518924471
Name:HAAS, DAVID CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CHARLES
Last Name:HAAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2001 CLUB MANOR DR
Mailing Address - Street 2:SUITE J
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-7411
Mailing Address - Country:US
Mailing Address - Phone:501-687-0488
Mailing Address - Fax:501-687-0489
Practice Address - Street 1:2001 CLUB MANOR DR
Practice Address - Street 2:SUITE J
Practice Address - City:MAUMELLE
Practice Address - State:AR
Practice Address - Zip Code:72113-7411
Practice Address - Country:US
Practice Address - Phone:501-687-0488
Practice Address - Fax:501-687-0489
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-04462084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR126913001Medicaid
AR15755000000OtherQUAL CHOICE
139724OtherVALUE OPTIONS
AR5J640OtherBLUE CROSS BLUE SHIELD
AR0004280953OtherAETNA
0574890000OtherMAGELLAN
041251OtherMENTAL HEALTH NETWORK
07685OtherCIGNA
AR5J640Medicare ID - Type Unspecified
0574890000OtherMAGELLAN