Provider Demographics
NPI:1467413013
Name:HAYNES, SHARON M (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:M
Last Name:HAYNES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3212 RAINBOW DR
Mailing Address - Street 2:
Mailing Address - City:RAINBOW CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35906-5805
Mailing Address - Country:US
Mailing Address - Phone:256-442-7683
Mailing Address - Fax:256-442-8357
Practice Address - Street 1:3212 RAINBOW DR
Practice Address - Street 2:
Practice Address - City:RAINBOW CITY
Practice Address - State:AL
Practice Address - Zip Code:35906-5805
Practice Address - Country:US
Practice Address - Phone:256-442-7683
Practice Address - Fax:256-442-8357
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA028818207Q00000X
ALMD20723207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPENDINGOtherBCBS
ALPENDINGMedicaid
GA00375141HMedicaid
ALPENDINGOtherBCBS
GA00375141HMedicaid
ALPENDINGMedicaid