Provider Demographics
NPI:1841385333
Name:HAINES, NORMAN W JR (MD)
Entity type:Individual
Prefix:
First Name:NORMAN
Middle Name:W
Last Name:HAINES
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 1:4810 N DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2341
Mailing Address - Country:US
Mailing Address - Phone:850-477-8109
Mailing Address - Fax:850-476-5313
Practice Address - Street 1:4810 N DAVIS HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2341
Practice Address - Country:US
Practice Address - Phone:850-477-8109
Practice Address - Fax:850-476-5313
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0031800207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
000289899001OtherUNITED HEALTH CARE
6903663OtherCIGNA
4647873OtherAETNA
Z014OtherHEALTH OPTIONS
FL037596900Medicaid
AL059020272OtherBCBS OF ALABAMA
AL000800448Medicaid
FL17410OtherBCBS OF FLORIDA
000289899001OtherUNITED HEALTH CARE
4647873OtherAETNA
AL000800448Medicaid