Provider Demographics
NPI:1417946559
Name:HAUGE, DAVID HANS (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:HANS
Last Name:HAUGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9314 PARK WEST BLVD
Mailing Address - Street 2:200 MEDICAL ARTS BLDG
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4353
Mailing Address - Country:US
Mailing Address - Phone:865-694-0577
Mailing Address - Fax:865-694-4720
Practice Address - Street 1:9314 PARK WEST BLVD
Practice Address - Street 2:200 MEDICAL ARTS BLDG
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4353
Practice Address - Country:US
Practice Address - Phone:865-694-0577
Practice Address - Fax:865-694-4720
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD20514207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3051732Medicaid
TN3051732Medicare ID - Type Unspecified
E45866Medicare UPIN