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General NPI Number Information
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NPI Number | 1871751412
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Entity Type | Individual
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Provider Name | TIMOTHY MICHAEL HAFFEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/30/2008
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Last Update Date | 05/20/2022
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Provider Practice Location Address
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Address Line | 147 REYNOIR ST STE 201
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City | BILOXI
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State | MS
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Zip | 39530
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Country | US
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Telephone | 228-392-6239
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Fax |
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Provider Business Mailing Address
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Address Line | 150 REYNOIR ST
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City | BILOXI
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State | MS
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Zip | 39530-4130
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Country | US
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Telephone | 228-436-1142
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 1761
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | PT13586
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License Number State | ND
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 23630
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License Number State | MS
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