Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 43090 | KY |
NPI | 1003922873 |
---|---|
Provider Name | David James Haustein |
First Address | Louisville, KY 40201-0909 |
Second Address | Louisville, KY 40202-3826 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 02/03/2017 |