Basic Information
| Provider Information | |||||||||
| NPI: | 1770550600 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HAYS MEDICAL CENTER, INC. | ||||||||
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| OtherOrganizationName: | HMG - HAYS FAMILY MEDICINE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2509 CANTERBURY DR | ||||||||
| Address2: | |||||||||
| City: | HAYS | ||||||||
| State: | KS | ||||||||
| PostalCode: | 676012233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7856235095 | ||||||||
| FaxNumber: | 7856235080 | ||||||||
| Practice Location | |||||||||
| Address1: | 2509 CANTERBURY DR | ||||||||
| Address2: | |||||||||
| City: | HAYS | ||||||||
| State: | KS | ||||||||
| PostalCode: | 676012233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7856235095 | ||||||||
| FaxNumber: | 7856235080 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2006 | ||||||||
| LastUpdateDate: | 01/13/2010 | ||||||||
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| AuthorizedOfficialLastName: | MOORE | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | B | ||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR, PHYSICIAN PRACTICES | ||||||||
| AuthorizedOfficialTelephone: | 7856232185 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 100098970F | 05 | KS | MEDICAID | 100098970I | 05 | KS | MEDICAID |