Provider Demographics
NPI:1255389474
Name:HAYNES, ROBERT R (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:R
Last Name:HAYNES
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1201 ALHAMBRA BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5238
Mailing Address - Country:US
Mailing Address - Phone:916-731-7925
Mailing Address - Fax:916-731-7975
Practice Address - Street 1:1201 ALHAMBRA BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5238
Practice Address - Country:US
Practice Address - Phone:916-731-7925
Practice Address - Fax:916-731-7975
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2015-10-28
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Provider Licenses
StateLicense IDTaxonomies
WAMD00042134207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8941461OtherSTATE CRIME VICTIMS
WA8453037Medicaid
WA0208862OtherSTATE L&I
WA8941461OtherSTATE CRIME VICTIMS
WAG8861154Medicare PIN