Healthcare Provider Details

I. General information

NPI: 1265408603
Provider Name (Legal Business Name): STEVEN MARK HAYDEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2006
Last Update Date: 12/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76297 TALLASSEE HWY
WETUMPKA AL
36092-5558
US

IV. Provider business mailing address

76297 TALLASSEE HWY
WETUMPKA AL
36092-5558
US

V. Phone/Fax

Practice location:
  • Phone: 334-514-1910
  • Fax:
Mailing address:
  • Phone: 334-514-1910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number13468
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: