Hazley, Kerrian A

Hazley, Kerrian A is an individual health care provider with primary practice located at 362 State Highway 83 , Defuniak Springs FL 32433-3800. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Hazley, Kerrian A can be contacted via phone (850) 892-8015.

Contact Information

Primary practice address
362 State Highway 83 Defuniak Springs FL 32433-3800
Fax: (850) 892-8457
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 051502 Connecticut
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME117182 Florida

Profile Details

NPI number 1689802993
LBN Legal business name Hazley, Kerrian A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 25th, 2009
Last updated Apr 13th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689802993 NPPES
Florida MEDICAID 011940500

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