Individual
SCOTTY JACK HAYNES
Active
Individual
SCOTTY JACK HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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