Healthcare Provider Details

I. General information

NPI: 1407933807
Provider Name (Legal Business Name): WILLIAM L HAITH JR. DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 11/15/2023
Certification Date: 11/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 MAIN ST
SACO ME
04072-1530
US

IV. Provider business mailing address

360 US HIGHWAY 1 BYP UNIT 102
PORTSMOUTH NH
03801-7105
US

V. Phone/Fax

Practice location:
  • Phone: 207-571-7991
  • Fax: 207-571-7990
Mailing address:
  • Phone: 603-314-8872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number1661
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: