Provider Demographics
NPI:1689784399
Name:HAUSER, RICHARD LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LEE
Last Name:HAUSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:615 HORSESHOE DR
Mailing Address - Street 2:SUITE G
Mailing Address - City:GRINNELL
Mailing Address - State:IA
Mailing Address - Zip Code:50112-4711
Mailing Address - Country:US
Mailing Address - Phone:641-236-1700
Mailing Address - Fax:641-236-1711
Practice Address - Street 1:615 HORSESHOE DR
Practice Address - Street 2:SUITE G
Practice Address - City:GRINNELL
Practice Address - State:IA
Practice Address - Zip Code:50112-4711
Practice Address - Country:US
Practice Address - Phone:641-236-1700
Practice Address - Fax:641-236-1711
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2010-07-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA282302084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
235924OtherMIDLANDS CHOICE
IA5094201Medicaid
IA48317OtherWELLMARK BCBS
235924OtherMIDLANDS CHOICE
IA48317OtherWELLMARK BCBS
IA5094201Medicaid