Provider Demographics
NPI:1205814589
Name:HASEK, OLIVER MARTIN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:OLIVER
Middle Name:MARTIN
Last Name:HASEK
Suffix:JR
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 1:7205 THOMAS DR # 1906
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32408-7501
Mailing Address - Country:US
Mailing Address - Phone:850-387-6290
Mailing Address - Fax:850-234-7961
Practice Address - Street 1:2600 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:BONIFAY
Practice Address - State:FL
Practice Address - Zip Code:32425-4264
Practice Address - Country:US
Practice Address - Phone:850-547-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL61068207Q00000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL370002000Medicaid
FL14863OtherBC/BS OF FL
FL61068OtherMEDICAL LICENSE
FL61068OtherMEDICAL LICENSE