=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710628110
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HAYDEN C SCHOEFFLER MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/07/2022
-----------------------------------------------------
Last Update Date | 07/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 401 PAT HARALSON DR UNIT 3
-----------------------------------------------------
City | BLAIRSVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30512-8454
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-487-7580
-----------------------------------------------------
Fax | 706-781-0995
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 401 PAT HARALSON DR UNIT 3
-----------------------------------------------------
City | BLAIRSVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30512-8454
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-487-7580
-----------------------------------------------------
Fax | 706-781-0995
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 101228
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------