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General NPI Number Information
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NPI Number | 1235133091
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Entity Type | Individual
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Provider Name | JAMES R HAYWARD D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 07/23/2012
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Provider Practice Location Address
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Address Line | 819 STATE ROUTE 664 N STE A
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City | LOGAN
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State | OH
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Zip | 43138-8540
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Country | US
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Telephone | 740-385-9614
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Fax | 740-380-2734
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Provider Business Mailing Address
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Address Line | PO BOX 228
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City | LOGAN
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State | OH
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Zip | 43138-0228
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Country | US
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Telephone | 740-380-8068
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Fax | 740-380-2734
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34002691H
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License Number State | OH
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