Individual
DR. DAVID KENNETH HAKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2019 JEFFERSON RD, STE A, NORTHFIELD, MN 55057-3258
(507) 645-9202
(507) 645-9203
Mailing address
2019 JEFFERSON RD, STE A, NORTHFIELD, MN 55057-3258
(507) 645-9202
(507) 645-9203
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
LD2735000
MN
152WC0802X
Corneal and Contact Management Optometrist
LD2735000
MN
152WP0200X
Pediatric Optometrist
LD2735000
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123686
U CARE, MN
MN
01
—
177K0HA
BLUE CROSS BLUE SHIELD MN
MN
05
—
4005210-00
—
MN
01
—
850754
AMERICA'S PPO
MN
Enumeration date
06/27/2005
Last updated
05/05/2011
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