Healthcare Provider Details

I. General information

NPI: 1700533015
Provider Name (Legal Business Name): EDWIN S HAYES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2022
Last Update Date: 03/07/2022
Certification Date: 03/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 E BROAD ST STE 101
COLUMBUS OH
43215-3989
US

IV. Provider business mailing address

720 E BROAD ST STE 101
COLUMBUS OH
43215-3989
US

V. Phone/Fax

Practice location:
  • Phone: 614-360-0122
  • Fax:
Mailing address:
  • Phone: 614-360-0122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: