Organization
HAYTI MEDICAL CLINIC, INC
Active
Other names
Extended Health Systems Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN HAYNES (CEO)
(573) 359-2930
Entity
Organization
Contact information
Practice address
1502 WARD AVE, CARUTHERSVILLE, MO 63830-2571
(573) 333-4244
(573) 333-4551
Mailing address
PO BOX 37, HAYTI, MO 63851-0037
(573) 359-2930
(573) 359-1304
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
11/15/2005
Last updated
08/22/2020
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