Provider Demographics
NPI:1356464523
Name:HAPWORTH, HUNTINGTON T (MD)
Entity Type:Individual
Prefix:
First Name:HUNTINGTON
Middle Name:T
Last Name:HAPWORTH
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 1469
Mailing Address - Street 2:
Mailing Address - City:PASCAGOULA
Mailing Address - State:MS
Mailing Address - Zip Code:39568-1469
Mailing Address - Country:US
Mailing Address - Phone:228-938-7000
Mailing Address - Fax:228-938-0705
Practice Address - Street 1:4105 HOSPITAL ST STE 112B
Practice Address - Street 2:
Practice Address - City:PASCAGOULA
Practice Address - State:MS
Practice Address - Zip Code:39581-5304
Practice Address - Country:US
Practice Address - Phone:228-938-0700
Practice Address - Fax:228-938-0705
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25576207LP2900X, 208VP0014X
MS19781207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51541333OtherBCBS O F AL
MS090000009Medicare PIN
AL51541333OtherBCBS O F AL