Provider Demographics
NPI:1710908496
Name:HAASIS, JOHN CHRISTIAN (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CHRISTIAN
Last Name:HAASIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6130
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29304-6130
Mailing Address - Country:US
Mailing Address - Phone:864-583-0053
Mailing Address - Fax:864-583-0390
Practice Address - Street 1:1330 BOILING SPRINGS ROAD
Practice Address - Street 2:SUITE 2700
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303
Practice Address - Country:US
Practice Address - Phone:864-583-0053
Practice Address - Fax:864-583-0390
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19459208VP0014X
NC9601331208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC571049338OtherBCBS
NC013KEOtherBCBS
NC89013KEMedicaid
SCGP1456Medicaid
SCGP2967Medicaid
NC8913096Medicaid
NC8913096Medicaid
SCGP2967Medicaid
NC89013KEMedicaid
SCG599526655Medicare PIN
SCG599525640Medicare PIN