Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD460350 | PA |
NPI | 1033377023 |
---|---|
Provider Name | Dr. Thorsen Wayne Haugen |
First Address | Danville, PA 17822-4903 |
Second Address | Danville, PA 17822-4238 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2008 |
Last Update Date | 24/06/2020 |