Basic Information
| Provider Information | |||||||||
| NPI: | 1396946687 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | PAUL N. HAYES, MD PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | NORWAY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 498701238 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9065639255 | ||||||||
| FaxNumber: | 9065639706 | ||||||||
| Practice Location | |||||||||
| Address1: | 500 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | NORWAY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 498701238 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9065639255 | ||||||||
| FaxNumber: | 9065639706 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | HAYES | ||||||||
| AuthorizedOfficialFirstName: | PAUL | ||||||||
| AuthorizedOfficialMiddleName: | N | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9065639255 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 41583-020 | WI | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 4301035335 | MI | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1099106 | 05 | MI | MEDICAID | 1487617296 | 01 | MI | INDIVIDUAL NPI NUMBER | OTHER | 0802203533 | 01 | MI | BLUE CROSS OF MICHIGAN | OTHER | 30119000 | 05 | WI | MEDICAID | PH35335 | 01 | MI | COMMERCIAL INSURANCE # | OTHER | 01007383 | 01 | MI | PREFERRED ONE | OTHER |