Provider Demographics
NPI:1619563772
Name:HAIGES, DEVON
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:
Last Name:HAIGES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2543 EVERMUR DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414-1401
Mailing Address - Country:US
Mailing Address - Phone:937-409-7090
Mailing Address - Fax:
Practice Address - Street 1:2543 EVERMUR DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-1401
Practice Address - Country:US
Practice Address - Phone:937-409-7090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSUNS347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle