Healthcare Provider Details

I. General information

NPI: 1588123590
Provider Name (Legal Business Name): WATSON HAYES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 06/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 S 24TH ST W STE 1
BILLINGS MT
59102-5659
US

IV. Provider business mailing address

4523 N 3150 E
LIBERTY UT
84310-9779
US

V. Phone/Fax

Practice location:
  • Phone: 406-656-2006
  • Fax: 406-655-0460
Mailing address:
  • Phone: 267-736-6335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. RYAN HAYES
Title or Position: OPTOMETRIST
Credential: OD
Phone: 267-736-6335