Individual
JUSTIN HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6451 BRENTWOOD STAIR RD, #200, FORT WORTH, TX 76112-3200
(817) 469-9700
Mailing address
1429 INDIAN SPGS, HAYNES MEDICINE PLLC, CARROLLTON, TX 75007-6001
(252) 412-5573
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2012-01485
NC
207P00000X
Emergency Medicine Physician
Primary
P9585
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
172TC
BCBSNC
NC
05
—
5921105
—
NC
Enumeration date
06/15/2009
Last updated
03/17/2015
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