Provider Demographics
NPI:1982771374
Name:HAYNES, JEFFREY L (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:L
Last Name:HAYNES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4767 HIGHWAY 58
Mailing Address - Street 2:STE 107
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37416-2282
Mailing Address - Country:US
Mailing Address - Phone:423-899-1010
Mailing Address - Fax:423-899-1016
Practice Address - Street 1:4767 HIGHWAY 58
Practice Address - Street 2:STE 107
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37416-2282
Practice Address - Country:US
Practice Address - Phone:423-899-1010
Practice Address - Fax:423-899-1016
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1981111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor