Healthcare Provider Details

I. General information

NPI: 1932113610
Provider Name (Legal Business Name): STEVEN CHARLES HADLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 W 23RD ST
PANAMA CITY FL
32405-2349
US

IV. Provider business mailing address

2636 EDGEWATER DRIVE
NICEVILLE FL
32444
US

V. Phone/Fax

Practice location:
  • Phone: 850-784-3936
  • Fax: 850-784-3539
Mailing address:
  • Phone: 850-678-8930
  • Fax: 850-784-3539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME91942
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: