Provider Demographics
NPI:1679703532
Name:HAAG, ERIC W
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:W
Last Name:HAAG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 S PARKER RD
Mailing Address - Street 2:A-106
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-2758
Mailing Address - Country:US
Mailing Address - Phone:303-755-1733
Mailing Address - Fax:303-306-9340
Practice Address - Street 1:1402 S PARKER RD
Practice Address - Street 2:A-106
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-2758
Practice Address - Country:US
Practice Address - Phone:303-755-1733
Practice Address - Fax:303-306-9340
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-24
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO200574237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist