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General NPI Number Information
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NPI Number | 1942411053
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Entity Type | Individual
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Provider Name | JEFFREY RAY HAFFNER RPH
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Gender | Male
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1506 ELIZABETH PIKE
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City | MINERAL WELLS
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State | WV
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Zip | 26150
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Country | US
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Telephone | 304-489-9086
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Fax |
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Provider Business Mailing Address
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Address Line | 1169 SMITH RD
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City | WATERFORD
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State | OH
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Zip | 45786-6203
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Country | US
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Telephone | 740-749-3609
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP0005438
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03-3-19902
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License Number State | OH
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