MEDICARE: DR. JAY HAYNER 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	207R00000X	Internal Medicine Physician	35066333	OH

Other Identifiers

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

General Provider Information

NPI Number	:	1396790507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAY HAYNER MD

Provider Business Mailing Address
First Line	:	4600 WESLEY AVE
Second Line	:	STE N
City	:	CINCINNATI
State	:	OH
Zip	:	45212-2298
Country	:	US
Telephone Number	:	513-246-7750
Fax Number	:	513-246-7852

Provider Business Practice Location Address
First Line	:	6010 S MASON MONTGOMERY RD
Second Line	:
City	:	MASON
State	:	OH
Zip	:	45040-3706
Country	:	US
Telephone Number	:	513-246-7000
Fax Number	:	513-229-6066

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	09/04/2012

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