MEDICARE: DR. ROGER G HAAG 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	CH0004144	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	350003745	OTHER		PALMETTO RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487767810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROGER G HAAG DC

Provider Business Mailing Address
First Line	:	111 W BROADWAY
Second Line	:
City	:	FORT MEADE
State	:	FL
Zip	:	33841
Country	:	US
Telephone Number	:	863-285-8686
Fax Number	:	863-285-9527

Provider Business Practice Location Address
First Line	:	111 W BROADWAY
Second Line	:
City	:	FORT MEADE
State	:	FL
Zip	:	33841
Country	:	US
Telephone Number	:	863-285-8686
Fax Number	:	863-285-9527

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

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	07/08/2007

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