Haefner, Susan Moore

Haefner, Susan Moore is an individual health care provider with primary practice located at 1200 N Beaver St , Flagstaff AZ 86001-3118. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, which is considered as her primary health care specialty. Haefner, Susan Moore can be contacted via phone (928) 773-2120.

Contact Information

Primary practice address
1200 N Beaver St Flagstaff AZ 86001-3118
Phone: (928) 773-2120
Fax: (928) 213-2189
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X L4961 Texas
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 27097 Arizona

Profile Details

NPI number 1912948530
LBN Legal business name Haefner, Susan Moore
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2006
Last updated Dec 18th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912948530 NPPES
Arizona MEDICAID 705347
Arizona MEDICAID 152394601

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