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NPI Code Detail

MEDICARE: BYRON HAITAS MD

MEDICARE:   BYRON  HAITAS  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
1207RC0000XCardiovascular Disease PhysicianMD018628TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275646119
Entity Type Code : Individual
Provider Name (Legal Business Name) : BYRON HAITAS MD
Provider Business Mailing Address
First Line : 2400 PATTERSON ST
Second Line : SUITE 304
City : NASHVILLE
State : TN
Zip : 37203-1562
Country : US
Telephone Number : 615-342-5975
Fax Number : 615-342-5919
Provider Business Practice Location Address
First Line : 2400 PATTERSON STREETT
Second Line : SUITE 304
City : NASHVILLE
State : TN
Zip : 37203
Country : US
Telephone Number : 615-342-5975
Fax Number : 615-342-5919
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2006
Last Update Date : 01/07/2022

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