Provider Demographics
NPI:1326577248
Name:HAYNES CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:HAYNES CHIROPRACTIC, INC.
Other - Org Name:HAYNES CHIROPRACTIC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:661-322-2875
Mailing Address - Street 1:3865 STOCKDALE HWY
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-2188
Mailing Address - Country:US
Mailing Address - Phone:661-322-2875
Mailing Address - Fax:661-397-8882
Practice Address - Street 1:3865 STOCKDALE HWY
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-2188
Practice Address - Country:US
Practice Address - Phone:661-322-2875
Practice Address - Fax:661-397-8882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-05
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC21998111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1649340688OtherHEALTH INSURANCE