Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | ME126033 | FL |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | R1J88 | MO |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | ME126033 | FL |
NPI | 1174549398 |
---|---|
Provider Name | Dr. Bruce Harwood Haughey |
First Address | Celebration, FL 34747-5436 |
Second Address | Celebration, FL 34747-5436 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 09/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
015010206 | (05) | MO |