Miles Alan Haeberle, PHYSICIAN ASSISTANT

NPI #1710496997 in Challis, Idaho

Provider Information

NPI Number: 1710496997
Entity Type: Individual
Name: Miles Alan Haeberle, PHYSICIAN ASSISTANT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PHYSICIAN ASSISTANT
Enumeration Date: Sep 20, 2017
Last Updated: Jun 1, 2020

Practice Location

Address: 611 CLINIC RD
City: Challis
State: Idaho
ZIP Code: 83226-4824
Phone: (208) 879-4351

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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