Haley, Jack M.

Haley, Jack M. is an individual health care provider with primary practice located at 2000 N. Boise Ave. , Loveland CO 80538-7282. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Haley, Jack M. can be contacted via phone (970) 635-4071.

Contact Information

Primary practice address
2000 N. Boise Ave. Loveland CO 80538-7282
Phone: (970) 635-4071
Fax: (303) 306-7753
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 735 Colorado
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA.000735 Colorado

Profile Details

NPI number 1477529519
LBN Legal business name Haley, Jack M.
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 28th, 2006
Last updated Jul 31st, 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 1477529519 NPPES
Colorado Other P01331724 RAILROAD MEDICARE
Colorado MEDICAID 55625029 RAILROAD MEDICARE

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