Organization
HEATHER A HAYNES MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HEATHER ANN HAYNES M.D. (PRESIDENT)
(419) 333-8231
Entity
Organization
Contact information
Practice address
2265 HAYES AVE, FREMONT, OH 43420-2632
(419) 333-8231
(419) 332-2553
Mailing address
2265 HAYES AVE, FREMONT, OH 43420-2632
(419) 333-8231
(419) 332-2553
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-090126
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2770078
—
OH
01
—
35-090126
MEDICAL LICENSE
OH
Enumeration date
08/15/2007
Last updated
04/03/2008
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