Jason P Haack
Otolaryngology/Facial Plastic Surgery
191 Overthrust Rd
Evanston
, Wyoming 82930-9261
Jason P Haack
Otolaryngology/Facial Plastic Surgery
191 Overthrust Rd
Evanston
, Wyoming 82930-9261
(307) 789-8664
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About
Features
Specialties
- Otolaryngology/Facial Plastic Surgery
Languages spoken
- English
Location
First Address
- Jason P Haack
- 191 Overthrust Rd
- Evanston, WY
- Zip : 82930-9261
- Fax : (307) 789-8664
- Phone : (307) 789-8721
Second Address
- Jason P Haack
- 191 Overthrust Rd
- Evanston, WY
- Zip : 82930-9261
- Fax : (307) 789-8664
- Phone : (307) 789-8721
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Where is Jason P Haack ’s practice located?
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Is Jason P Haack a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 7953A | WY |
National Provider Identifier
| NPI | 1407832728 |
|---|---|
| Provider Name | Jason P Haack |
| First Address | Evanston, WY 82930-9261 |
| Second Address | Evanston, WY 82930-9261 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/12/2005 |
| Last Update Date | 15/03/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 06329001 | BCBS WY (01) | WY |
| 1407832728 | (05) | WY |
| 433920700 | (05) | MN |
| H98446 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.