Healthcare Provider Details

I. General information

NPI: 1891736419
Provider Name (Legal Business Name): BRADLEY L. HAYES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1331 S A ST
ELWOOD IN
46036-1942
US

IV. Provider business mailing address

250 N SHADELAND AVE
INDIANAPOLIS IN
46219-4959
US

V. Phone/Fax

Practice location:
  • Phone: 765-552-4600
  • Fax: 765-552-4680
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number01042666A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: