Individual
BRANDON HAAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
217 S 3RD ST, DANVILLE, KY 40422-1823
(859) 335-9041
(859) 335-9072
Mailing address
PO BOX 1650, AKRON, OH 44309-1650
(330) 864-8900
(330) 869-8924
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
38865
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000330903
ANTHEM
KY
05
—
2496553
—
OH
01
—
3000721
BWC
WV
05
—
3810004518
—
WV
01
—
50005459
PASSPORT
KY
05
—
64080898
—
KY
Enumeration date
07/15/2006
Last updated
07/08/2007
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