Provider Demographics
NPI:1699760777
Name:HAUGHTON, DAVID DELMAR (OD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:DELMAR
Last Name:HAUGHTON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1717 N FLAGLER DR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-6555
Mailing Address - Country:US
Mailing Address - Phone:561-655-1111
Mailing Address - Fax:561-835-9521
Practice Address - Street 1:1717 N FLAGLER DR
Practice Address - Street 2:SUITE 7
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-6555
Practice Address - Country:US
Practice Address - Phone:561-655-1111
Practice Address - Fax:561-835-9521
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-15
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOP570152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2294580001Medicare NSC
T93721Medicare UPIN
FL19051Medicare PIN