Provider Demographics
NPI:1629035506
Name:HAYNES, DAVID WILLIAM (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WILLIAM
Last Name:HAYNES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21280 CONCH DR
Mailing Address - Street 2:
Mailing Address - City:CUDJOE KEY
Mailing Address - State:FL
Mailing Address - Zip Code:33042-4110
Mailing Address - Country:US
Mailing Address - Phone:305-744-0751
Mailing Address - Fax:
Practice Address - Street 1:1300 DOUGLAS CIR
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4536
Practice Address - Country:US
Practice Address - Phone:305-293-4600
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice