| Doctor Name: | RODGER K HAYNES |
| NPI Number: | 1285810879 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 00017129 |
| Business Practice Address: | Exit 102 Off I - 40 1/2 Mi South San Fidel, NM - 870490130 |
| Business Phone Number: | 5055525385 |
| Business Fax Number: | 5055525473 |
| Mailing Address: | Exit 102 Off I - 40 1/2 Mi South, Po Box 130 SAN FIDEL |
| State: | NM |
| Postal Code: | 870490130 |
| Phone Number: | 5055525385 |
| Fax Number: | 5055525473 |
| NPI Enumeration Date: | 01/14/2008 |
| NPI Last Update Date: | 01/14/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 146L00000X |
| License Number: | 00017129 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Emergency Medical Service Providers |
| Taxonomy Classification: | Emergency Medical Technician, Paramedic |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An EMT, Paramedic is an individual trained and certified to perform advanced life support (ALS) in medical emergencies based on individual state boards. |