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NPI Code Detail

MEDICARE: DR. JASON THADEOUS HAYES M.D.

MEDICARE: DR. JASON THADEOUS HAYES M.D.
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
1207R00000XInternal Medicine Physician61172KY
2207R00000XInternal Medicine PhysicianM6181TX
3207R00000XInternal Medicine Physician69293GA
4207R00000XInternal Medicine Physician42706TN
5207R00000XInternal Medicine PhysicianMD.201342LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
111809713OTHERGACAQH

General Provider Information

NPI Number : 1265625289
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JASON THADEOUS HAYES M.D.
Provider Business Mailing Address
First Line : 6175 HICKORY FLAT HWY STE 110
Second Line :
City : CANTON
State : GA
Zip : 30115-7236
Country : US
Telephone Number : 678-395-7046
Fax Number : 844-874-7569
Provider Business Practice Location Address
First Line : 4300 PACES FERRY RD SE STE 500
Second Line :
City : ATLANTA
State : GA
Zip : 30339-5714
Country : US
Telephone Number : 678-395-7046
Fax Number : 844-874-7569
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2007
Last Update Date : 01/29/2026

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