Healthcare Provider Details

I. General information

NPI: 1467431890
Provider Name (Legal Business Name): ROBERT C. HAYES OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 09/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16233 HIGHWAY 280 SUITE C
CHELSEA AL
35043-8301
US

IV. Provider business mailing address

PO BOX 376
CHELSEA AL
35043-0376
US

V. Phone/Fax

Practice location:
  • Phone: 205-678-2020
  • Fax: 205-678-2021
Mailing address:
  • Phone: 205-678-2020
  • Fax: 205-678-2021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberS-683-TA-175
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: