Individual
DR. ANDRE VONTRAL HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
229 RUGGED CREEK DR, STOCKBRIDGE, GA 30281-4568
(404) 783-0792
Mailing address
229 RUGGED CREEK DR, STOCKBRIDGE, GA 30281-4568
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
68818
GA
208D00000X
General Practice Physician
MD.29119
AL
Other
Enumeration date
09/28/2009
Last updated
11/29/2018
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