Provider Demographics
NPI:1497958227
Name:HAUSMANN, MICHAEL ANTHONY JR (OD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:HAUSMANN
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-5631
Mailing Address - Country:US
Mailing Address - Phone:402-326-8802
Mailing Address - Fax:
Practice Address - Street 1:707 E KANSAS PLZ
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5866
Practice Address - Country:US
Practice Address - Phone:620-276-3381
Practice Address - Fax:620-275-7507
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1996152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist