Provider Demographics
NPI:1770787343
Name:HAUPTMAN, GARRETT ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:ALAN
Last Name:HAUPTMAN
Suffix:
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 1:7135 NW 11TH PLACE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605
Mailing Address - Country:US
Mailing Address - Phone:352-331-0090
Mailing Address - Fax:352-331-0090
Practice Address - Street 1:7135 NW 11TH PLACE
Practice Address - Street 2:SUITE A
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605
Practice Address - Country:US
Practice Address - Phone:352-331-0090
Practice Address - Fax:352-331-0094
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME100127207Y00000X, 207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1770787343OtherINDIVIDUAL NPI
FLME100127OtherMEDICAL LICENSE
FL1215121983OtherGROUP NPI
FL42755AMedicare PIN