Provider Demographics
NPI:1912060427
Name:HAYWOOD, J TIMOTHY (DMD)
Entity Type:Individual
Prefix:DR
First Name:J
Middle Name:TIMOTHY
Last Name:HAYWOOD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 INVERNESS CENTER DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-7633
Mailing Address - Country:US
Mailing Address - Phone:205-991-8939
Mailing Address - Fax:205-995-5028
Practice Address - Street 1:202 INVERNESS CENTER DR
Practice Address - Street 2:SUITE 301
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-7633
Practice Address - Country:US
Practice Address - Phone:205-991-8939
Practice Address - Fax:205-995-5028
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL41611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice