| Doctor Name: | DEWAYNE CARL HAVERSTICK |
| NPI Number: | 1770830960 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | NREMTP |
| License Number: | 0800200 |
| Business Practice Address: | 453 South Novacel Dr Fort Rucker, AL - 36362 |
| Business Phone Number: | 2515189110 |
| Business Fax Number: | |
| Mailing Address: | 104 S Springview Dr, ENTERPRISE |
| State: | AL |
| Postal Code: | 363305060 |
| Phone Number: | 2515189110 |
| Fax Number: | |
| NPI Enumeration Date: | 08/07/2012 |
| NPI Last Update Date: | 08/07/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 146L00000X |
| License Number: | 0800200 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Emergency Medical Service Providers |
| Taxonomy Classification: | Emergency Medical Technician, Paramedic |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An EMT, Paramedic is an individual trained and certified to perform advanced life support (ALS) in medical emergencies based on individual state boards. |