| Doctor Name: | MR. SAMUEL HAYWOOD |
| NPI Number: | 1174938351 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | R.T. (R) |
| License Number: | 439042 |
| Business Practice Address: | 4855 Se 10th St Tecumseh, KS - 665429424 |
| Business Phone Number: | 7855050106 |
| Business Fax Number: | |
| Mailing Address: | 4855 Se 10th St, TECUMSEH |
| State: | KS |
| Postal Code: | 665429424 |
| Phone Number: | 7855050106 |
| Fax Number: | |
| NPI Enumeration Date: | 06/25/2014 |
| NPI Last Update Date: | 06/25/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2471C3402X |
| License Number: | 439042 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | Radiography |
| Taxonomy Definition: | |