McMinnville Orthopaedic Clinic

Organization Active NPI Orthopaedic Surgery Physician · Hartford, KY

NPI 1306809199 · NPPES record last updated May 26, 2021

Key facts

NPI
1306809199
Entity type
Organization (NPI type 2)
Primary specialty
Orthopaedic Surgery Physician 207X00000X
Legal business name
MCMINNVILLE ORTHOPAEDIC CLINIC
Practice address
1215 Old Main St
Hartford, KY 42347-1619
Phone
(270) 730-5344
NPI assigned
Apr 11, 2006
Organization subpart
No

Authorized official

Name
Douglas Brandt Haynes, M.D.
Title
Partner
Phone
(931) 473-9624

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207X00000X Yes
Durable Medical Equipment & Medical Supplies 332B00000X
Customized Equipment (DME) 332BC3200X
Prosthetic/Orthotic Supplier 335E00000X

Addresses

Primary practice location

1215 Old Main St
Hartford, KY 42347-1619

Mailing address

207 Oak Park
MC Minnville, TN 37110-1336
Phone (931) 473-9624

Other identifiers

IdentifierTypeStateIssuer
3191762MedicaidTN
3812480MedicaidTN
3384004MedicaidTN

Other providers in Hartford, KY

All providers in Hartford, KY · Orthopaedic Surgery Physician in Kentucky

Sources for this page

Verify at the official NPI Registry.