Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 2152 | SD |
NPI | 1033199310 |
---|---|
Provider Name | Dr. Daniel J Hafner |
First Address | Rapid City, SD 57701-7374 |
Second Address | Rapid City, SD 57701-7374 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6300162 | (05) | SD |
D25305 | (02) | SD |