Provider Demographics
NPI:1366559833
Name:ROBERT & WILLIAM HASS, OPTOMETRISTS, PROFESSIONAL CORP
Entity type:Organization
Organization Name:ROBERT & WILLIAM HASS, OPTOMETRISTS, PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:HASS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:989-288-3265
Mailing Address - Street 1:8777 MONROE RD
Mailing Address - Street 2:
Mailing Address - City:DURAND
Mailing Address - State:MI
Mailing Address - Zip Code:48429-1062
Mailing Address - Country:US
Mailing Address - Phone:989-288-3265
Mailing Address - Fax:989-288-4011
Practice Address - Street 1:8777 MONROE RD
Practice Address - Street 2:
Practice Address - City:DURAND
Practice Address - State:MI
Practice Address - Zip Code:48429-1062
Practice Address - Country:US
Practice Address - Phone:989-288-3265
Practice Address - Fax:989-288-4011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002808332H00000X
MI4901002552332H00000X
152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0284720002Medicare NSC
MI0G36400Medicare PIN