Individual
THOMAS SCOTT HASLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1003 WILLOW CREEK RD, PRESCOTT, AZ 86301-1641
(928) 771-6100
Mailing address
5831 N BRONCO LN, PRESCOTT VALLEY, AZ 86314-5892
(801) 660-8887
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/16/2013
Last updated
01/03/2019
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