Healthcare Provider Details
I. General information
NPI: 1902245277
Provider Name (Legal Business Name): HAYES EYE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/20/2013
Last Update Date: 06/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16233 HIGHWAY 280 SUITE C
CHELSEA AL
35043-8355
US
IV. Provider business mailing address
16233 HIGHWAY 280 SUITE C
CHELSEA AL
35043-8355
US
V. Phone/Fax
- Phone: 205-678-2020
- Fax: 205-678-2021
- Phone: 205-678-2020
- Fax: 205-678-2021
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | S-683-TA-175 |
| License Number State | AL |
VIII. Authorized Official
Name: DR.
ROBERT
HAYES
Title or Position: OPTOMETRIST
Credential: OD
Phone: 205-678-2020