Provider Demographics
NPI:1417979881
Name:HAYNES, MARY JANE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:JANE
Last Name:HAYNES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2000 CHURCH ST
Mailing Address - Street 2:BOX 110
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37236-0001
Mailing Address - Country:US
Mailing Address - Phone:615-284-5071
Mailing Address - Fax:615-284-3349
Practice Address - Street 1:2000 CHURCH ST
Practice Address - Street 2:BOX 110
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37236-0001
Practice Address - Country:US
Practice Address - Phone:615-284-5071
Practice Address - Fax:615-284-3349
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV196862080N0001X
TN2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine