Provider Demographics
NPI:1548258130
Name:HAYNES, ALLAN LOUIS JR (MD)
Entity type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:LOUIS
Last Name:HAYNES
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:3601 4TH ST
Mailing Address - Street 2:MAIL STOP 7260
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430-0002
Mailing Address - Country:US
Mailing Address - Phone:806-743-1810
Mailing Address - Fax:806-743-1335
Practice Address - Street 1:3601 4TH ST
Practice Address - Street 2:MAIL STOP 7260
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-0002
Practice Address - Country:US
Practice Address - Phone:806-743-1810
Practice Address - Fax:806-743-1335
Is Sole Proprietor?:No
Enumeration Date:2005-10-08
Last Update Date:2021-12-02
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Provider Licenses
StateLicense IDTaxonomies
TXM 7253208800000X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D43159Medicare UPIN
TX8G7384Medicare PIN