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General NPI Number Information
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NPI Number | 1376605857
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Entity Type | Individual
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Provider Name | ROBERT BRAD HAYES D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 06/26/2019
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Provider Practice Location Address
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Address Line | 26652 E MAIN ST
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City | WEST POINT
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State | MS
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Zip | 39773-7544
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Country | US
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Telephone | 662-494-1869
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Fax | 662-494-7883
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Provider Business Mailing Address
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Address Line | 3823 HIGHWAY 80 E STE 400
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City | PEARL
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State | MS
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Zip | 39208-4275
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Country | US
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Telephone | 601-664-0456
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3129-00
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License Number State | MS
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