Healthcare Provider Details

I. General information

NPI: 1477534055
Provider Name (Legal Business Name): DENNIS F HAYES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 11/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7710 MERCY ROAD SUITE 404
OMAHA NE
68124-2346
US

IV. Provider business mailing address

7710 MERCY ROAD SUITE 404
OMAHA NE
68124-2346
US

V. Phone/Fax

Practice location:
  • Phone: 402-390-6001
  • Fax:
Mailing address:
  • Phone: 402-390-6001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number13788
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: