Healthcare Provider Details

I. General information

NPI: 1013942424
Provider Name (Legal Business Name): JAMES BLAIR HAYS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 11/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2502 CROCKETT DR
BROWNWOOD TX
76801-5900
US

IV. Provider business mailing address

PO BOX 878
BROWNWOOD TX
76804-0878
US

V. Phone/Fax

Practice location:
  • Phone: 325-643-5521
  • Fax: 325-643-2647
Mailing address:
  • Phone: 325-646-2523
  • Fax: 325-646-7141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberD4147
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: