Healthcare Provider Details

I. General information

NPI: 1376567487
Provider Name (Legal Business Name): TERESA GRAY HAYES MD, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 BOB PETERS GRV STE 202
COLORADO SPRINGS CO
80909-4533
US

IV. Provider business mailing address

2003 KOOTENAI HEALTH WAY
COEUR D ALENE ID
83814-6051
US

V. Phone/Fax

Practice location:
  • Phone: 719-365-6568
  • Fax:
Mailing address:
  • Phone: 208-625-5085
  • Fax: 208-625-5731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberM13846
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberMD-19459
License Number StateHI
# 3
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberDR.0058164
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: