Individual
BRIAN HASLAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1125 MADISON ST, JEFFERSON CITY, MO 65101-5227
(573) 632-5000
(573) 634-2033
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2019033221
MO
208M00000X
Hospitalist Physician
2019033221
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200072135
—
MO
Enumeration date
07/11/2018
Last updated
07/11/2024
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