Provider Demographics
NPI:1114218120
Name:HAYNAL, WILLIAM BRENDON (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BRENDON
Last Name:HAYNAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2620 EAST BARNETT RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-8383
Mailing Address - Country:US
Mailing Address - Phone:541-789-8100
Mailing Address - Fax:888-948-2624
Practice Address - Street 1:555 BLACK OAK DRIVE
Practice Address - Street 2:SUITE 300 B
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504
Practice Address - Country:US
Practice Address - Phone:541-789-8100
Practice Address - Fax:541-789-8101
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD606218832084P0800X, 2084S0012X
ORMD1959232084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry