Healthcare Provider Details
I. General information
NPI: 1700601184
Provider Name (Legal Business Name): MARK D HAYS MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/20/2024
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9089 DAYTON PIKE
SODDY DAISY TN
37379-4313
US
IV. Provider business mailing address
PO BOX 238
SODDY DAISY TN
37384-0238
US
V. Phone/Fax
- Phone: 423-451-0622
- Fax: 423-451-0624
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0202X |
| Taxonomy | Pediatric Cardiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MARK
D
HAYS
Title or Position: OWNER
Credential: MD
Phone: 423-432-7049