MEDICARE: BENJAMIN HAYES MD, PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207NP0225X	Pediatric Dermatology Physician	41674	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4155108	OTHER	TN	BCBS

General Provider Information

NPI Number	:	1003963976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN HAYES MD, PHD

Provider Business Mailing Address
First Line	:	3098 CAMPBELL STATION PKWY STE A201
Second Line	:
City	:	SPRING HILL
State	:	TN
Zip	:	37174-4405
Country	:	US
Telephone Number	:	615-302-5000
Fax Number	:	615-302-5006

Provider Business Practice Location Address
First Line	:	3098 CAMPBELL STATION PKWY STE A201
Second Line	:
City	:	SPRING HILL
State	:	TN
Zip	:	37174-4405
Country	:	US
Telephone Number	:	615-302-5000
Fax Number	:	615-302-5006

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	01/18/2010

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