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General NPI Number Information
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NPI Number | 1144491788
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Entity Type | Organization
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Legal Business Name | DAVID A. HAINE, O.D. P.C.
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Dates
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Enumeration Date | 03/21/2008
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Last Update Date | 07/16/2008
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Provider Practice Location Address
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Address Line | 306 ENGLAND STREET
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City | ASHLAND
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State | VA
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Zip | 23005-2110
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Country | US
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Telephone | 804-798-8593
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Fax | 804-798-4052
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Provider Business Mailing Address
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Address Line | 306 ENGLAND STREET
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City | ASHLAND
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State | VA
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Zip | 23005-2110
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Country | US
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Telephone | 804-798-8593
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Fax | 804-798-4052
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. DAVID ARTHUR HAINE
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Credential | OD
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Telephone | 804-798-8593
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618000638
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License Number State | VA
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