Provider Demographics
NPI:1902965601
Name:HAYNER, JAMES B (MD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:B
Last Name:HAYNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 709
Mailing Address - Street 2:
Mailing Address - City:PINCKNEY
Mailing Address - State:MI
Mailing Address - Zip Code:48169-0709
Mailing Address - Country:US
Mailing Address - Phone:517-273-9090
Mailing Address - Fax:517-518-8629
Practice Address - Street 1:1225 WEST GRAND RIVER AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-3970
Practice Address - Country:US
Practice Address - Phone:517-273-9090
Practice Address - Fax:517-518-8629
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301054402207R00000X, 207RS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N97110001Medicare PIN
MIF37572Medicare UPIN