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Individual

DR. LESTER N HAUGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2416 LYNNDALE RD, SUITE 110, FERNANDINA BEACH, FL 32034-5252
(941) 752-1900
(941) 752-1905
Mailing address
1790 GARDENIA ST, FERNANDINA BEACH, FL 32034-1980
(941) 752-1900
(941) 752-1905

Taxonomy

Speciality
Code
Description
License number
State
207LA0401X
Addiction Medicine (Anesthesiology) Physician
Primary
ME78635
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
58706
BLUE CROSS BLUE SHIELD
FL
Enumeration date
09/12/2005
Last updated
03/10/2008
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