Individual
DR. BRENT ALAN HASKELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1338 PHAY AVE, CANON CITY, CO 81212-2302
(719) 285-2646
(719) 285-2647
Mailing address
1338 PHAY AVE, CANON CITY, CO 81212-2302
(719) 285-2646
(719) 285-2647
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
34749
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13329
CO ANTHEM PIN
CO
01
—
89F14HA
BCBS OF MINN. PIN
CO
01
—
P00027804
RAILROAD MEDICARE PIN
CO
Enumeration date
04/06/2006
Last updated
12/07/2012
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