Healthcare Provider Details

I. General information

NPI: 1902879760
Provider Name (Legal Business Name): DARIN LEE HAUG DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 12/06/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2305 SOUTH 65 HIGHWAY
MARSHALL MO
65340-3702
US

IV. Provider business mailing address

2305 SOUTH 65 HIGHWAY
MARSHALL MO
65340-3702
US

V. Phone/Fax

Practice location:
  • Phone: 660-866-7431
  • Fax: 660-831-3361
Mailing address:
  • Phone: 660-866-7431
  • Fax: 660-831-3314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2002023836
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2002023836
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: