Dr Lance Fay Haseltine, MD is a
General Practice physician based in Shell Lake, Wisconsin. Dr Lance Fay Haseltine is licensed to practice in Wisconsin (license number 35039-20) and his current practice location is 24521 Poquette Lake Rd, Shell Lake, Wisconsin. He can be reached at his office (for appointments etc.) via phone at
(612) 991-4889.
NPI number for Dr Lance Fay Haseltine is 1093010001 and his current mailing address is 24521 Poquette Lake Rd, Shell Lake, Wisconsin. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1093010001.
Physician's Profile
| Full Name | Dr Lance Fay Haseltine |
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| Gender | Male |
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| Speciality | General Practice |
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| Location | 24521 Poquette Lake Rd, Shell Lake, Wisconsin |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1093010001
- Provider Enumeration Date: 01/22/2011
- Last Update Date: 05/05/2024
Medical Identifiers
Medical identifiers for Dr Lance Fay Haseltine such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1093010001 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208D00000X | General Practice | 33541 (Minnesota) | Secondary |
| 208D00000X | General Practice | 35039-20 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Lance Fay Haseltine is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Lance Fay Haseltine, MD
24521 Poquette Lake Rd,
Shell Lake, WI 54871-9240
Ph: (612) 991-4889 | Dr Lance Fay Haseltine, MD
24521 Poquette Lake Rd,
Shell Lake, WI 54871-9240
Ph: (612) 991-4889 |
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