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General NPI Number Information
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NPI Number | 1912724352
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Entity Type | Individual
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Provider Name | BRIAN HAYES
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Gender | Male
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Dates
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Enumeration Date | 09/25/2024
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 8120 SMOKY ROW RD
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City | POWELL
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State | OH
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Zip | 43065-7500
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Country | US
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Telephone | 614-420-4763
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Fax |
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Provider Business Mailing Address
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Address Line | 6605 LONGSHORE STREET SUITE: 240 #218
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City | DUBLIN
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State | OH
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Zip | 43017
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Country | US
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Telephone | 614-402-8286
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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 | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number | HIC03029
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License Number State | OH
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