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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

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