Healthcare Provider Details

I. General information

NPI: 1528357100
Provider Name (Legal Business Name): ANDREW JAMES KAYES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2011
Last Update Date: 12/02/2025
Certification Date: 04/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E 2ND ST
COUDERSPORT PA
16915-8161
US

IV. Provider business mailing address

1001 E 2ND ST
COUDERSPORT PA
16915-8161
US

V. Phone/Fax

Practice location:
  • Phone: 814-274-9300
  • Fax:
Mailing address:
  • Phone: 814-274-9300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD452739
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD452739
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: