Individual
ADDISON G HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3118 S LAFOUNTAIN ST, KOKOMO, IN 46902-3710
(765) 864-4160
(765) 400-4467
Mailing address
8003 CASTLEWAY DR, INDIANAPOLIS, IN 46250-1946
(317) 576-1335
(317) 343-6562
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02004638A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201314620
—
IN
Enumeration date
07/23/2012
Last updated
02/17/2026
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