Healthcare Provider Details

I. General information

NPI: 1265743850
Provider Name (Legal Business Name): SEAN PATRICK HAIGHT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2010
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 HOVEY RD
PENSACOLA FL
32508-1044
US

IV. Provider business mailing address

NMOTC 220 HOVEY RD
PENSACOLA FL
32508
US

V. Phone/Fax

Practice location:
  • Phone: 850-452-8051
  • Fax:
Mailing address:
  • Phone: 850-452-8051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number28329
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: