Jack Leroy Haling, MD is a
Pediatrics physician based in Mount Shasta, California. Jack Leroy Haling is licensed to practice in California (license number C28244) and his current practice location is 824 Pine St, Mount Shasta, California. He can be reached at his office (for appointments etc.) via phone at
(530) 926-4528.
NPI number for Jack Leroy Haling is 1861482002 and his current mailing address is Po Box 339, Mount Shasta, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1861482002.
Physician's Profile
| Full Name | Jack Leroy Haling |
|---|
| Gender | Male |
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| Speciality | Pediatrics |
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| Location | 824 Pine St, Mount Shasta, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1861482002
- Provider Enumeration Date: 10/27/2005
- Last Update Date: 03/21/2012
Medical Identifiers
Medical identifiers for Jack Leroy Haling such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1861482002 | NPI | - | NPPES |
| 00C282440 | Medicaid | CA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208000000X | Pediatrics | C28244 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jack Leroy Haling is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jack Leroy Haling, MD
Po Box 339,
Mount Shasta, CA 96067-0339
Ph: (530) 926-5613 | Jack Leroy Haling, MD
824 Pine St,
Mount Shasta, CA 96067-2137
Ph: (530) 926-4528 |
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