Individual
GERALD A HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3000 COLISEUM DR, HAMPTON, VA 23666-5963
(757) 599-4922
Mailing address
PO BOX 7422, HAMPTON, VA 23666-0422
(757) 599-4922
(757) 599-4927
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110002566
VA
363AM0700X
Medical Physician Assistant
335
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20414
PIN
WY
Enumeration date
07/25/2006
Last updated
12/21/2007
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