Provider Demographics
NPI:1942314356
Name:HASELOFF, BRIAN JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JAMES
Last Name:HASELOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3501 S SONCY RD STE 1002
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-4932
Mailing Address - Country:US
Mailing Address - Phone:806-341-2188
Mailing Address - Fax:
Practice Address - Street 1:3501 S SONCY RD STE 1002
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-4932
Practice Address - Country:US
Practice Address - Phone:806-341-2188
Practice Address - Fax:806-731-4300
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9727207QS0010X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine