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Dr. Lester N Hauge
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NPI Number Detailed Information
Provider Information:
Name: | Dr. Lester N Hauge |
Gender: | M |
Provider License Number If Given: | ME78635 |
NPI Information:
NPI: | 1679568182 |
Entity Type (Individual or Organization): |
1-ind |
Enumeration Date: | 9/12/2005 |
Last Update Date: | 3/10/2008 |
Provider Business Mailing Address:
Address: | 1790 GARDENIA ST Fernandina Beach, FL 32034 |
Phone Number: | 9417521900 |
Fax Number: | 9417521905 |
Provider Business Practice Location Address:
Address: | 2416 LYNNDALE RD SUITE 110 Fernandina Beach, FL 32034 |
Phone Number: | 9417521900 |
Fax Number: | 9417521905 |
Provider Taxonomy:
Primary: | 207LA0401X |
Secondary (if any): | |
State: | FL |