Provider Demographics
NPI:1932391190
Name:RAY A. HAAS, MD
Entity Type:Organization
Organization Name:RAY A. HAAS, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE & BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:LINSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-462-3488
Mailing Address - Street 1:1471 JASON RD STE B
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-1278
Mailing Address - Country:US
Mailing Address - Phone:317-462-3488
Mailing Address - Fax:317-462-0754
Practice Address - Street 1:1471 JASON RD STE B
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-1278
Practice Address - Country:US
Practice Address - Phone:317-462-3488
Practice Address - Fax:317-462-0754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01022756208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
221360Medicare PIN
INC24831Medicare UPIN