Provider Demographics
NPI:1841688090
Name:PAUL JOHN HAYNER MD PC
Entity type:Organization
Organization Name:PAUL JOHN HAYNER MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-325-0505
Mailing Address - Street 1:1406 MARINE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:OR
Mailing Address - Zip Code:97103-3808
Mailing Address - Country:US
Mailing Address - Phone:503-325-0505
Mailing Address - Fax:503-325-1212
Practice Address - Street 1:1406 MARINE DRIVE
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103-3808
Practice Address - Country:US
Practice Address - Phone:503-325-0505
Practice Address - Fax:503-325-1212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-22
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care