JASON P HAACK (NPI# 1407832728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407832728 |
| Entity Type | Individual |
| Full Name | JASON P HAACK |
| Credential | M.D. |
| Practice Address |
191 Overthrust Rd Evanston WY 82930-9261 |
| Practice Telephone | 3077898721 |
| Practice Fax Number | 3077898664 |
| Mailing Telephone | 3077898721 |
| Mailing Fax Number | 3077898664 |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2017-03-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
7953A | WY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | BCBS WY | 06329001 | 01 |
| MN | 433920700 | 05 | |
| WY | 1407832728 | 05 |
| Street Address |
191 OVERTHRUST RD |
| City | EVANSTON |
| State | WY |
| Zip Code | 82930-9261 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669947610 | Stacy Jo Kennedy | Nurse Practitioner | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2018-10-05 |
| 1194226266 | High Desert Psychology and Wellness | Clinic/Center | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2018-02-23 |
| 1790172807 | Uinta Health Lab, LLC | Clinical Medical Laboratory | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2015-04-16 |
| 1023404514 | Utah Podiatry Group PC | Podiatrist | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2015-04-10 |
| 1962804443 | Barker Family Health, LLC | Nurse Practitioner | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2014-09-16 |
| 1790067999 | Corrie Carver | Nurse Practitioner | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2011-09-13 |
| 1730335423 | Southwest Wyoming Ent Inc | Otolaryngology | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2008-08-13 |
| 1255476131 | Adam K Fuller | Psychologist | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2007-02-20 |
| 1144328949 | Jared Breck Barton | Surgery | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598398935 | Colby Kim Gomez | Physical Therapist | 190 Arrowhead Dr, Evanston, Wy 82930, Evanston, WY 82930 | 2020-02-13 |
| 1164808382 | Marilyn Carol Edgeworth Tacoma | Registered Nurse | 1037 Morse Lee St, Evanston, WY 82930 | 2015-08-11 |
| 1699159723 | Impact Physical Therapy LLC | Clinic/Center | 96 Yellow Creek Road, Evanston, WY 82930 | 2015-07-18 |
| 1578942421 | Mark Carstensen | Case Manager/Care Coordinator | 219 7th Street, Evanston, WY 82930 | 2015-05-26 |
| 1013396241 | Jennifer Carstensen | Case Manager/Care Coordinator | 325 Arrowhead Drive, Evanston, WY 82930 | 2015-05-20 |
| 1780083782 | Christa Lena Barker | Nurse Practitioner | 191 Overthrust Road, Evanston, WY 82930 | 2014-08-15 |
| 1366865339 | Don Mckay Francom | Dentist | 170 Arrowhead Dr. Suite 1, Evanston, WY 82930 | 2014-01-28 |
| 1417228370 | Premier Surgical Center, LLC | Clinic/Center | 195 Overthrust Road, Evanston, WY 82930 | 2012-01-24 |
| 1588959324 | Mejia D Williams | Social Worker | 190 Overthrust Road, Evanston, WY 82930 | 2011-06-09 |
| 1225327000 | Richard Jay Capener | Family Medicine | 196 Arrowhead Dr Ste 1, Evanston, WY 82930 | 2011-04-01 |
| Find all providers in zip 82930 | ||||
| Taxonomy Code | 207YX0905X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngology/Facial Plastic Surgery |
| An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437518545 | Wyo Ent PC | Otolaryngology | 407 S Medical Arts Ct Ste F, Gillette, WY 82716-3372 | 2016-02-17 |
Please comment or provide details below to improve the information on JASON P HAACK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.