Hakes, David Kenneth
Hakes, David Kenneth is an individual health care provider with primary practice located at 2019 Jefferson Rd Ste A, Northfield MN 55057-3258. He recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Pediatrics. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Hakes, David Kenneth can be contacted via phone (507) 645-9202.Contact Information
Primary practice address
2019 Jefferson Rd Ste A
Northfield MN 55057-3258
Phone: (507) 645-9202
Fax: (507) 645-9203
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | LD2735000 | Minnesota |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | LD2735000 | Minnesota |
| Eye and Vision Services Providers / Pediatrics | 152WP0200X | LD2735000 | Minnesota |
Profile Details
| NPI number | 1992701536 |
|---|---|
| LBN Legal business name | Hakes, David Kenneth |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 27th, 2005 |
| Last updated | May 5th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992701536 | NPPES |
| Minnesota | MEDICAID | 4005210-00 | |
| Minnesota | Other | 177K0HA | |
| Minnesota | Other | 850754 | |
| Minnesota | Other | 123686 |
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