Provider Demographics
NPI:1639289655
Name:HABERMAN, ANALISA R (DO)
Entity Type:Individual
Prefix:DR
First Name:ANALISA
Middle Name:R
Last Name:HABERMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:621 S ILLINOIS AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-5489
Mailing Address - Country:US
Mailing Address - Phone:641-494-3041
Mailing Address - Fax:641-494-3059
Practice Address - Street 1:621 S ILLINOIS AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-5489
Practice Address - Country:US
Practice Address - Phone:641-422-6900
Practice Address - Fax:641-422-6909
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2021-01-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA3184207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA19792OtherWELLMARK
IA3153460Medicaid
IA19792OtherWELLMARK
IA3153460Medicaid