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Individual
JOHN C HAIRSTON
Active
Individual
JOHN C HAIRSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
L4417
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007524368
AETNA
TX
05
—
152994302
—
TX
01
—
4248755
BLUE LINK
TX
01
—
5472630
CIGNA
TX
01
—
8W5050
BLUE CROSS BLUE SHIELD
TX
01
—
P000388708
MEDICARE RAIL ROAD
TX
Enumeration date
09/14/2006
Last updated
05/08/2008
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