Provider Demographics
NPI:1275504938
Name:HAINES, JOE D JR (MD)
Entity Type:Individual
Prefix:MR
First Name:JOE
Middle Name:D
Last Name:HAINES
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:75 FREEDOM PKWY STE C
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-4939
Practice Address - Country:US
Practice Address - Phone:919-545-0911
Practice Address - Fax:919-545-0096
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101266309207Q00000X
ARE11917207Q00000X
DCMD046744207Q00000X
FLME138605207Q00000X
NC2010-01612207Q00000X
SC40131207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC5266BMedicare PIN
NCNC5266AMedicare PIN