Individual
DR. DEMONDES HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 NORTH STATE STREET, DEPARTMENT OF MEDICINE DIVISION OF PULMONARY, JACKSON, MS 39216-4643
(601) 984-5650
(601) 984-5658
Mailing address
2500 N STATE ST, DIVISION OF PULMONARY, JACKSON, MS 39216-4500
(601) 984-5650
(601) 984-5658
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
17062
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06003098
—
MS
Enumeration date
06/09/2006
Last updated
04/10/2014
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