Individual
DR. HOLLAND HOYT HAYNIE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD26719
Contact information
Practice address
3870 COLUMBIA AVE, OSAGE BEACH, MO 65065-8689
(573) 708-7600
Mailing address
PO BOX 777, RICHLAND, MO 65556-0777
(573) 708-7600
(541) 573-8893
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2024012818
MO
207Q00000X
Family Medicine Physician
MD26719
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278996
—
OR
01
—
838331006
BC/BS
OR
01
—
MD26719
LICENSE
OR
Enumeration date
10/11/2006
Last updated
07/30/2024
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