Haley, Tony O.

Haley, Tony O. is an individual health care provider with primary practice located at 3 Professional Park Dr Ste 31 , Johnson City TN 37604-6529. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Haley, Tony O. can be contacted via phone (423) 975-5650.

Contact Information

Primary practice address
3 Professional Park Dr Ste 31 Johnson City TN 37604-6529
Phone: (423) 975-5650
Fax: (423) 975-5652
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD15750 Tennessee

Profile Details

NPI number 1154317220
LBN Legal business name Haley, Tony O.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2005
Last updated Jul 21st, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154317220 NPPES
Tennessee MEDICAID 3025919
Tennessee MEDICAID 3388129
Tennessee MEDICAID Q013212

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