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General NPI Number Information
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NPI Number | 1437289865
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Entity Type | Organization
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Legal Business Name | STACY J HAYNES MD PC
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 02/26/2010
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Provider Practice Location Address
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Address Line | 3825 LORNA RD SUITE 240
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City | BIRMINGHAM
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State | AL
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Zip | 35244-3005
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Country | US
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Telephone | 256-831-8100
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Fax | 256-831-8128
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Provider Business Mailing Address
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Address Line | 3825 LORNA RD SUITE 240
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City | BIRMINGHAM
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State | AL
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Zip | 35244-3005
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Country | US
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Telephone | 256-831-8100
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Fax | 256-831-8128
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Authorized Official
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Title or Position | OWNER
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Name | STACY JEANENE HAYNES
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Credential | MD
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Telephone | 256-831-8100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 15551
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License Number State | AL
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