Haynesworth, Dominic T.

Haynesworth, Dominic T. is an sole proprietor health care provider with primary practice located at 2351 E 22Nd St , Cleveland OH 44115-3111. He recently has 2 registered licenses in different health care specialties including Emergency Medical Service Providers / Personal Emergency Response Attendant, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Haynesworth, Dominic T. can be contacted via phone (216) 861-6200.

Contact Information

Primary practice address
2351 E 22Nd St Cleveland OH 44115-3111
Phone: (216) 861-6200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Emergency Medical Service Providers / Personal Emergency Response Attendant 146D00000X 35046582 Ohio
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 46583 Ohio

Profile Details

NPI number 1073550752
LBN Legal business name Haynesworth, Dominic T.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 1st, 2006
Last updated Aug 10th, 2021 - about 3 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 1073550752 NPPES
Ohio Other 942460636429 CARESOURCE
Ohio MEDICAID 0464939 CARESOURCE

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