Individual
STEPHEN H. HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1833 W 21ST ST, CLOVIS, NM 88101-4023
(575) 763-5585
(575) 763-6051
Mailing address
1833 W 21ST ST, CLOVIS, NM 88101-4023
(575) 763-5585
(575) 763-6051
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
82-61
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19018
—
NM
01
—
P00347709
RAILROAD MEDICARE PIN
NM
Enumeration date
05/11/2006
Last updated
10/17/2024
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