Organization
MCMINNVILLE ORTHOPAEDIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS BRANDT HAYNES M.D. (PARTNER)
(931) 473-9624
Entity
Organization
Contact information
Practice address
1215 OLD MAIN ST, HARTFORD, KY 42347-1619
(270) 730-5344
Mailing address
207 OAK PARK, MC MINNVILLE, TN 37110-1336
(931) 473-9624
(931) 473-7718
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3191762
—
TN
05
—
3384004
—
TN
05
—
3812480
—
TN
Enumeration date
04/11/2006
Last updated
05/26/2021
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