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Organization
DPM HAIRSTON 01 FL LLC
Active
Organization
DPM HAIRSTON 01 FL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EARLIE OWENS HAIRSTON II D.P.M. (OWNER)
(352) 683-6618
Entity
Organization
Contact information
Practice address
12900 CORTEZ BLVD STE 102, BROOKSVILLE, FL 34613-6897
(352) 683-6618
(352) 683-5722
Mailing address
12900 CORTEZ BLVD STE 102, BROOKSVILLE, FL 34613-6897
(352) 683-6618
(352) 683-5722
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
K7562
FL
Other
Enumeration date
04/04/2007
Last updated
01/30/2025
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