Healthcare Provider Details

I. General information

NPI: 1528047982
Provider Name (Legal Business Name): ROBERT ELLIOT HAIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 HOVEY ROAD MITCHELL CENTER FOR POW STUDIES
PENSACOLA FL
32508-1047
US

IV. Provider business mailing address

10196 BITTERN DR
PENSACOLA FL
32507-7208
US

V. Phone/Fax

Practice location:
  • Phone: 850-452-2157
  • Fax: 850-452-9342
Mailing address:
  • Phone: 850-452-2157
  • Fax: 850-452-9342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberME79857
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: