Healthcare Provider Details

I. General information

NPI: 1972523660
Provider Name (Legal Business Name): JEFFREY M HAINES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

174 CONCORD ST SUITE 160
PETERBOROUGH NH
03458-1250
US

IV. Provider business mailing address

174 CONCORD ST SUITE 160
PETERBOROUGH NH
03458-1250
US

V. Phone/Fax

Practice location:
  • Phone: 603-924-6774
  • Fax: 603-924-6778
Mailing address:
  • Phone: 603-924-6774
  • Fax: 603-924-6778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number7541
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number7541
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: