Individual
DONNA CAROL HALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
687 MARIETTA HWY, CANTON, GA 30114-2608
(770) 479-8040
(770) 479-7871
Mailing address
687 MARIETTA HWY, CANTON, GA 30114-2608
(770) 479-8040
(770) 479-7871
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
040916
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07/27/1959
DATE OF BIRTH
—
Enumeration date
04/21/2006
Last updated
10/30/2019
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