Basic Information
| Provider Information | |||||||||
| NPI: | 1417184680 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAYNES | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | M R | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1518 E KALISPELL CT | ||||||||
| Address2: | |||||||||
| City: | ANDOVER | ||||||||
| State: | KS | ||||||||
| PostalCode: | 670027982 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2528645790 | ||||||||
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| Practice Location | |||||||||
| Address1: | 939 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | WICHITA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 672033608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3166170680 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2009 | ||||||||
| LastUpdateDate: | 06/23/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RA0401X | 04-42127 | KS | N | Allopathic & Osteopathic Physicians | Internal Medicine | Addiction Medicine | 207R00000X | 04-42127 | KS | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207PT0002X | 04-42127 | KS | N | Allopathic & Osteopathic Physicians | Emergency Medicine | Medical Toxicology | 207P00000X | 04-42127 | KS | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207R00000X | P9873 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.