Individual
DAVID GENE HADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10345 ORANGEWOOD BLVD, ORLANDO, FL 32821-8239
(407) 352-6900
(407) 352-6163
Mailing address
10345 ORANGEWOOD BLVD, ORLANDO, FL 32821-8239
(407) 352-6900
(407) 352-6163
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
67120
OH
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME0059965
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
054222900
—
FL
01
—
0666956
AETNA HMO QPOS PROVIDER #
—
01
—
12237X
BLUE CROSS BLUE SHIELD PR
—
01
—
4205668
AETNA PPO POS PROVIDER #
—
01
—
593224058001
PRUCARE PROVIDER #
—
01
—
6421534009
CIGNA PROVIDER #
—
Enumeration date
10/16/2006
Last updated
01/19/2010
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