Organization
SOUTHWEST WYOMING ENT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON P HAACK MD (OWNER)
(307) 789-8721
Entity
Organization
Contact information
Practice address
191 OVERTHRUST RD, EVANSTON, WY 82930-9261
(307) 789-8721
(307) 789-8664
Mailing address
191 OVERTHRUST RD, EVANSTON, WY 82930-9261
(307) 789-8721
(307) 789-8664
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
207YS0123X
Facial Plastic Surgery Physician
—
—
Other
Enumeration date
08/13/2008
Last updated
10/24/2013
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