Provider Demographics
NPI:1003237447
Name:HAYNES, MORGAN (DOM, MS)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:HAYNES
Suffix:
Gender:M
Credentials:DOM, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8338 COMANCHE RD NE
Mailing Address - Street 2:STE. A
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-2357
Mailing Address - Country:US
Mailing Address - Phone:505-270-2747
Mailing Address - Fax:
Practice Address - Street 1:8338 COMANCHE RD NE
Practice Address - Street 2:STE. A
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-2357
Practice Address - Country:US
Practice Address - Phone:505-270-2747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM838171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist