Healthcare Provider Details

I. General information

NPI: 1982910253
Provider Name (Legal Business Name): HAYDEN VISION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2010
Last Update Date: 03/27/2023
Certification Date: 03/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 BELLEMEADE AVE
EVANSVILLE IN
47714-0100
US

IV. Provider business mailing address

PO BOX 722
HENDERSON KY
42419-0722
US

V. Phone/Fax

Practice location:
  • Phone: 812-477-3937
  • Fax: 812-477-9797
Mailing address:
  • Phone: 812-477-3937
  • Fax: 812-477-9797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number01043538
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: GREGORY L HAYDEN
Title or Position: SOLE MEMBER/OWNER
Credential:
Phone: 812-477-3937