Basic Information
| Provider Information | |||||||||
| NPI: | 1447352190 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAYES | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8055 O ST | ||||||||
| Address2: | STE 302 | ||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685102564 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024864783 | ||||||||
| FaxNumber: | 4024864933 | ||||||||
| Practice Location | |||||||||
| Address1: | 8101 O ST | ||||||||
| Address2: | STE 302 | ||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685102646 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024864783 | ||||||||
| FaxNumber: | 4024864933 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/02/2006 | ||||||||
| LastUpdateDate: | 06/07/2011 | ||||||||
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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 | 207V00000X | 19535 | NE | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 10025954300 | 05 | NE | MEDICAID | N/A | 01 | NE | COVENTRY | OTHER | 31776 | 01 | NE | BCBS | OTHER | 4095 | 01 | NE | MIDLAND'S CHOICE | OTHER | 07-00154 | 01 | NE | UHC | OTHER | N/A | 01 | NE | TRICARE | OTHER |