Individual
MR. ANTHONY A HAULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2860 CREEKSIDE CIRCLE, MEDFORD, OR 97504
(541) 779-8367
(541) 779-7471
Mailing address
700 NE 87TH AVE, VANCOUVER, WA 98664-1913
(360) 882-2778
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
MD21164
OR
207RG0100X
Gastroenterology Physician
Primary
MD61224828
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005591005
REGENCE BLUE CROSS
OR
05
—
158918
—
OR
05
—
USA242450
—
CA
Enumeration date
01/25/2006
Last updated
02/03/2022
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