Healthcare Provider Details

I. General information

NPI: 1528078417
Provider Name (Legal Business Name): OLIVER WESLEY HAYES III D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 W GREENLAWN AVE
LANSING MI
48910-2819
US

IV. Provider business mailing address

D128 WEST FEE HALL
EAST LANSING MI
48824
US

V. Phone/Fax

Practice location:
  • Phone: 517-334-2286
  • Fax: 517-334-2726
Mailing address:
  • Phone: 517-355-3503
  • Fax: 517-432-1167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number5101008310
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: