# RANDY P. HAUSTED M.D. INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548254139
- **Authorized official:** RANDY P HAUSTED M.D. (OWNER/ PATHOLOGIST)
- **Authorized official phone:** (707) 963-6288

## Contact information

- **Practice address:** 10 WOODLAND RD, ST. HELENA, CA 94574-9554
- **Practice address phone:** (707) 963-6288
- **Practice address fax:** (707) 967-5684
- **Mailing address:** PO BOX 270067, SAINT LOUIS, MO 63127-0067
- **Mailing address phone:** (707) 241-8205
- **Mailing address fax:** (314) 856-0635

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | Yes |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/09/2005
- **Last updated:** 08/05/2014