Provider Demographics
NPI:1790765626
Name:HALSEY, ALAN BARTON (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:BARTON
Last Name:HALSEY
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 1:3658 LITHIA PINECREST RD
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33596-6305
Mailing Address - Country:US
Mailing Address - Phone:813-681-6537
Mailing Address - Fax:813-661-3227
Practice Address - Street 1:3658 LITHIA PINECREST RD
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-6305
Practice Address - Country:US
Practice Address - Phone:813-681-6537
Practice Address - Fax:813-661-3227
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0043624207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1660645009OtherCIGNA
FL243295OtherAVMED
FL0205357OtherUNITED HEALTH CARE
FL05659OtherBCBS
FL4083694OtherAETNA PROVIDER NUMBER
FL047403700Medicaid
FL05659OtherBCBS
FL243295OtherAVMED