MEDICARE: WILLIAM BARRETT HAYNOS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	D0063871	MD
2	207RC0000X	Cardiovascular Disease Physician	MD441895	PA

General Provider Information

NPI Number	:	1093786923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM BARRETT HAYNOS MD

Provider Business Mailing Address
First Line	:	100 N ACADEMY AVE
Second Line	:
City	:	DANVILLE
State	:	PA
Zip	:	17822-4903
Country	:	US
Telephone Number	:	570-271-6144
Fax Number	:	570-271-6578

Provider Business Practice Location Address
First Line	:	100 N ACADEMY AVE
Second Line	:
City	:	DANVILLE
State	:	PA
Zip	:	17822-4409
Country	:	US
Telephone Number	:	570-271-6523
Fax Number	:	570-271-8056

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	08/10/2020

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