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Individual

SCOTTY JACK HAYNES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1113 MURFREESBORO RD, SUITE 106, #343, FRANKLIN, TN 37064-1306
(615) 550-7127
(855) 291-1894
Mailing address
1113 MURFREESBORO RD, SUITE 106, #343, FRANKLIN, TN 37064-1306
(615) 550-7127
(855) 291-1894

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD45839
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1520725
TN
01
BP1-0018027
INSTITUTIONAL PERMIT
01
P00935972
RAILROAD MEDICARE
TN
Enumeration date
06/12/2007
Last updated
11/11/2015
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