Basic Information
| Provider Information | |||||||||
| NPI: | 1295725943 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAYES | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2007 W FRANKLIN ST | ||||||||
| Address2: | SUITE B | ||||||||
| City: | EVANSVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 477125112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8124227244 | ||||||||
| FaxNumber: | 8124219180 | ||||||||
| Practice Location | |||||||||
| Address1: | 2007 W FRANKLIN ST | ||||||||
| Address2: | SUITE B | ||||||||
| City: | EVANSVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 477125112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8124227244 | ||||||||
| FaxNumber: | 8124219180 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2005 | ||||||||
| LastUpdateDate: | 03/10/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 01034113 | IN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 000000221260 | 01 | IN | BLUE CROSS BLUE SHIELD | OTHER | 100247910B | 05 | IN | MEDICAID | 080184468 | 01 | IN | RAILROAD MEDICARE | OTHER |