Provider Demographics
NPI:1306973060
Name:HAYNES NEUROSUGICAL GROUP, P.A.
Entity type:Organization
Organization Name:HAYNES NEUROSUGICAL GROUP, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:SIVLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-787-8676
Mailing Address - Street 1:801 PRINCETON AVE SW
Mailing Address - Street 2:SUITE 310
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35211-1310
Mailing Address - Country:US
Mailing Address - Phone:205-787-8676
Mailing Address - Fax:205-785-7944
Practice Address - Street 1:801 PRINCETON AVE SW
Practice Address - Street 2:SUITE 310
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1310
Practice Address - Country:US
Practice Address - Phone:205-787-8676
Practice Address - Fax:205-785-7944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16869207T00000X
AL11156207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1902849300OtherDR. ROBERT J. JOHNSON JR.
AL000089898Medicaid
AL528700620Medicaid
AL000015654Medicaid
AL1518905116OtherDR. RESIT CEM CEZAYIRLI
ALC74543Medicare UPIN
AL1518905116OtherDR. RESIT CEM CEZAYIRLI
AL000089898Medicare ID - Type UnspecifiedDR. ROBERT J. JOHNSON JR.
AL528700620Medicaid