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Organization
GRACE A HAYNES PC
Active
Organization
GRACE A HAYNES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRACE ANDREA HAYNES MD (PRESIDENT)
(480) 505-3276
Entity
Organization
Contact information
Practice address
4824 E BASELINE RD STE 140, MESA, AZ 85206
(480) 505-3276
(480) 545-9594
Mailing address
4824 E BASELINE RD STE 140, MESA, AZ 85206-4680
(480) 969-4040
(480) 830-1042
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
199895
—
AZ
Enumeration date
02/28/2008
Last updated
06/12/2018
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