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General NPI Number Information
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NPI Number | 1851341317
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Entity Type | Individual
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Provider Name | WILLIAM WALTER HAYNES MD
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Gender | Male
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 09/16/2009
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Provider Practice Location Address
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Address Line | 415D ROBERTSON BLVD W WALTER HAYNES
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City | WALTERBORO
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State | SC
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Zip | 29488
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Country | US
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Telephone | 843-549-8444
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Fax | 843-549-8499
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Provider Business Mailing Address
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Address Line | PO BOX 751649
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City | CHARLOTTE
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State | NC
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Zip | 28275-1649
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Country | US
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Telephone | 843-789-1620
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Fax | 843-724-2440
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 8425
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License Number State | SC
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