Individual
LOGAN MATHEW HAYNIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
80 NEWNAN STATION DRIVE, SUITE A, NEWNAN, GA 30265
(770) 251-2060
(678) 854-9235
Mailing address
PO BOX 73709, NEWNAN, GA 30271-3709
(770) 251-2060
(678) 854-9235
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN211179
GA
Other
Enumeration date
04/21/2015
Last updated
01/18/2016
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