Healthcare Provider Details

I. General information

NPI: 1366559833
Provider Name (Legal Business Name): ROBERT & WILLIAM HASS, OPTOMETRISTS, PROFESSIONAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 10/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8777 MONROE RD
DURAND MI
48429-1062
US

IV. Provider business mailing address

8777 MONROE RD
DURAND MI
48429-1062
US

V. Phone/Fax

Practice location:
  • Phone: 989-288-3265
  • Fax: 989-288-4011
Mailing address:
  • Phone: 989-288-3265
  • Fax: 989-288-4011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number4901002808
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number4901002552
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT M HASS
Title or Position: VICE PRESIDENT
Credential: O.D.
Phone: 989-288-3265