Individual
HALEY E DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
907 E LAMAR ALEXANDER PKWY, MARYVILLE, TN 37804-5015
(865) 977-5534
(865) 981-2154
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4380
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q071790
—
TN
Enumeration date
01/19/2021
Last updated
10/27/2025
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