Provider Demographics
NPI:1821080458
Name:HAAS, JEFFREY A (DO)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:A
Last Name:HAAS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 W AJ HWY
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-3733
Mailing Address - Country:US
Mailing Address - Phone:423-586-4336
Mailing Address - Fax:423-585-4343
Practice Address - Street 1:1530 W AJ HWY
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3733
Practice Address - Country:US
Practice Address - Phone:423-586-4336
Practice Address - Fax:423-585-4343
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO01307207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4011630OtherBCBS
TN3305914Medicaid
G17855Medicare UPIN
TN4011630OtherBCBS