Provider Demographics
NPI:1154437580
Name:HAIK, WILLIAM E (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:E
Last Name:HAIK
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 1:928 MAR WALT DR # A
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-6706
Mailing Address - Country:US
Mailing Address - Phone:850-862-4759
Mailing Address - Fax:850-864-4438
Practice Address - Street 1:928 MAR WALT DR # A
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-6706
Practice Address - Country:US
Practice Address - Phone:850-862-4759
Practice Address - Fax:850-864-4438
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0035422207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL038801700Medicaid
FL46122OtherBCBS
FL46122Medicare PIN
FLD54953Medicare UPIN