Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 036769 | GA |
NPI | 1043250269 |
---|---|
Provider Name | James Patrick Haley |
First Address | Canton, GA 30114-5256 |
Second Address | Woodstock, GA 30189-4880 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 05/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000539987E | (05) | GA |
000539987F | (05) | GA |
000539987G | (05) | GA |
F55878 | (02) | GA |