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NPI Code Detail

MEDICARE: DR. LORI M HAUN OD

MEDICARE: DR. LORI M HAUN OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist2368WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10008OTHERWIWPS STATE PART B
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164517074
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LORI M HAUN OD
Provider Business Mailing Address
First Line : S2845 WHITE EAGLE RD
Second Line :
City : BARABOO
State : WI
Zip : 53913-9064
Country : US
Telephone Number : 608-355-1240
Fax Number : 608-355-9643
Provider Business Practice Location Address
First Line : S2845 WHITE EAGLE RD
Second Line :
City : BARABOO
State : WI
Zip : 53913-9064
Country : US
Telephone Number : 608-355-1240
Fax Number : 608-355-5166
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 02/01/2022

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