Provider Demographics
NPI:1194043091
Name:HAUS, JASON RONALD (MD)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:RONALD
Last Name:HAUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1719 W. BIG BEAVER
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084
Mailing Address - Country:US
Mailing Address - Phone:248-458-0400
Mailing Address - Fax:248-458-0310
Practice Address - Street 1:1719 W. BIG BEAVER
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084
Practice Address - Country:US
Practice Address - Phone:248-458-0400
Practice Address - Fax:248-458-0310
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-17
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301096316207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology