Provider Demographics
NPI:1487695755
Name:HAUSER, RAYMOND JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:JOSEPH
Last Name:HAUSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 81
Mailing Address - Street 2:
Mailing Address - City:BOWERS
Mailing Address - State:PA
Mailing Address - Zip Code:19511-0081
Mailing Address - Country:US
Mailing Address - Phone:610-682-6522
Mailing Address - Fax:610-683-9894
Practice Address - Street 1:1 S HOME AVE
Practice Address - Street 2:
Practice Address - City:TOPTON
Practice Address - State:PA
Practice Address - Zip Code:19562-1317
Practice Address - Country:US
Practice Address - Phone:610-682-1275
Practice Address - Fax:610-682-1272
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD016890E207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0768014Medicaid
PA0768014Medicaid