Healthcare Provider Details

I. General information

NPI: 1083541890
Provider Name (Legal Business Name): MARIE HAYES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 BARCLAY DR
MADISON GA
30650-4621
US

IV. Provider business mailing address

1250 CONFEDERATE RD
MADISON GA
30650-2252
US

V. Phone/Fax

Practice location:
  • Phone: 706-438-3003
  • Fax:
Mailing address:
  • Phone: 706-438-3003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number390200000X
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: