Individual
JONATHAN HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
840 PINE ST, STE 500, MACON, GA 31201-2100
(478) 633-8682
(478) 633-8698
Mailing address
840 PINE ST, STE 500, MACON, GA 31201-2100
(478) 633-8682
(478) 633-8698
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
007073
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007073
GA LIC NUMBER
GA
Enumeration date
01/15/2014
Last updated
01/15/2014
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