Provider Demographics
NPI:1003027590
Name:HAINES, FREDERICK D (DC)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:D
Last Name:HAINES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 NW 6TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-2994
Mailing Address - Country:US
Mailing Address - Phone:352-377-7373
Mailing Address - Fax:352-371-1721
Practice Address - Street 1:2720 NW 6TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-2994
Practice Address - Country:US
Practice Address - Phone:352-377-7373
Practice Address - Fax:352-371-1721
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor