Provider Demographics
NPI:1770525651
Name:HAUG, ROBERT WALTER (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WALTER
Last Name:HAUG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1466 RIVERSIDE DR
Mailing Address - Street 2:STE C
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37406-4323
Mailing Address - Country:US
Mailing Address - Phone:423-643-2211
Mailing Address - Fax:423-643-2210
Practice Address - Street 1:1466 RIVERSIDE DR
Practice Address - Street 2:STE C
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37406-4323
Practice Address - Country:US
Practice Address - Phone:423-643-2211
Practice Address - Fax:423-643-2210
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNDC0000001918111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNU87569Medicare UPIN