Healthcare Provider Details

I. General information

NPI: 1659357010
Provider Name (Legal Business Name): DAVID W HAYES D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 10/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2023 PROFESSIONAL CENTER DR
ORANGE PARK FL
32073-4472
US

IV. Provider business mailing address

PO BOX 476
HOOD RIVER OR
97031-0016
US

V. Phone/Fax

Practice location:
  • Phone: 904-272-2020
  • Fax: 904-276-4386
Mailing address:
  • Phone: 619-846-8658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberDOS-1052
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberOS12357
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: