Individual
ERIC W HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2710 S RIFE MEDICAL LN, ROGERS, AR 72758-1452
(479) 338-8000
(479) 338-3056
Mailing address
PO BOX 507, LOWELL, AR 72745-0507
(913) 647-4100
(913) 647-4120
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201034161
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
C003203
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376077338
—
MO
05
—
200788720A
—
OK
05
—
221077001
—
AR
01
—
5CL80
BCBS ARKANSAS
AR
01
—
P01899051
RAILROAD
AR
Enumeration date
04/17/2017
Last updated
06/18/2021
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