MEDICARE: DR. ROBERT N HABERLE DC

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	DC6999	TX

General Provider Information

NPI Number	:	1912991043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT N HABERLE DC

Provider Business Mailing Address
First Line	:	307 W RUSK ST
Second Line	:
City	:	JACKSONVILLE
State	:	TX
Zip	:	75766-2337
Country	:	US
Telephone Number	:	903-586-4460
Fax Number	:

Provider Business Practice Location Address
First Line	:	307 W RUSK ST
Second Line	:
City	:	JACKSONVILLE
State	:	TX
Zip	:	75766-2337
Country	:	US
Telephone Number	:	903-586-4460
Fax Number	:

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

Provider Enumeration Date	:	09/05/2005
Last Update Date	:	07/08/2007

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