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General NPI Number Information
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NPI Number | 1033107016
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Entity Type | Individual
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Provider Name | MATTHEW JOHN HAAG DO
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Gender | Male
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Dates
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Enumeration Date | 10/12/2005
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Last Update Date | 05/15/2017
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Provider Practice Location Address
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Address Line | 115 SUMMERS HOSPITAL RD
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City | HINTON
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State | WV
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Zip | 25951-5172
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Country | US
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Telephone | 304-466-2918
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Fax | 304-466-2917
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Provider Business Mailing Address
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Address Line | 100 AIRPORT GARDENS ROAD SUITE 311
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City | HAZARD
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State | KY
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Zip | 41701-9529
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Country | US
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Telephone | 606-487-7503
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Fax | 606-439-6927
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2134
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License Number State | WV
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