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General NPI Number Information
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NPI Number | 1750444931
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Entity Type | Individual
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Provider Name | JOHN GEORGE HAIDINYAK MD
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Gender | Male
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 03/06/2009
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Provider Practice Location Address
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Address Line | 4920 NORTHEAST STALLINGS DRIVE
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City | NACOGDOCHES
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State | TX
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Zip | 75961
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Country | US
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Telephone | 936-569-9481
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Fax |
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Provider Business Mailing Address
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Address Line | 1329 N UNIVERSITY DR SUITE E1
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City | NACOGDOCHES
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State | TX
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Zip | 75961
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Country | US
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Telephone | 936-564-9164
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Fax | 936-560-2538
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MDFS222
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License Number State | TX
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