Provider Demographics
NPI:1962639104
Name:WALTERS HAYGOOD, CHRISTEN LYNEL (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTEN
Middle Name:LYNEL
Last Name:WALTERS HAYGOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHRISTEN
Other - Middle Name:W
Other - Last Name:HAYGOOD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 23666
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39225-3666
Mailing Address - Country:US
Mailing Address - Phone:601-200-4749
Mailing Address - Fax:601-200-5929
Practice Address - Street 1:971 LAKELAND DR
Practice Address - Street 2:SUITE 750
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4643
Practice Address - Country:US
Practice Address - Phone:601-200-5955
Practice Address - Fax:601-200-5943
Is Sole Proprietor?:No
Enumeration Date:2009-06-15
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS24411207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology