MEDICARE: DR. WILLIAM M HAAS D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	7394	AZ
2	111NR0400X	Rehabilitation Chiropractor	7394	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	Z103320	OTHER	AZ	MEDICARE ID-PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AZ0939450	OTHER	AZ	BCBS ID

General Provider Information

NPI Number	:	1144223561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM M HAAS D.C.

Provider Business Mailing Address
First Line	:	13260 N 94TH DR
Second Line	:	SUITE 205
City	:	PEORIA
State	:	AZ
Zip	:	85381-4240
Country	:	US
Telephone Number	:	623-583-6570
Fax Number	:	623-583-6571

Provider Business Practice Location Address
First Line	:	13260 N 94TH DR
Second Line	:	SUITE 205
City	:	PEORIA
State	:	AZ
Zip	:	85381-4240
Country	:	US
Telephone Number	:	623-583-6570
Fax Number	:	623-583-6571

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	11/06/2007

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Directions to “ DR. WILLIAM M HAAS D.C.” Practice Location

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