Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 28091 | KY |
NPI | 1013001841 |
---|---|
Provider Name | Laurie Haas |
First Address | Toledo, OH 43604-7102 |
Second Address | Lexington, KY 40509-2121 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 22/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000195179 | ANTHEM (01) | KY |
64280910 | (05) | KY |