Provider Demographics
NPI:1235246257
Name:DAFFIN, SIDNEY ALDERMAN III (MD)
Entity Type:Individual
Prefix:DR
First Name:SIDNEY
Middle Name:ALDERMAN
Last Name:DAFFIN
Suffix:III
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 1:746 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-2524
Mailing Address - Country:US
Mailing Address - Phone:850-763-8812
Mailing Address - Fax:850-763-0056
Practice Address - Street 1:746 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-2524
Practice Address - Country:US
Practice Address - Phone:850-763-8812
Practice Address - Fax:850-763-0056
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME10644207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL03065ZOtherMEDICARE PROVIDER
FL72568OtherGROUP ID
FL72568OtherGROUP ID
D50722Medicare UPIN