MEDICARE: PATRICIA A HAYES PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	1168	WI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	970009353	OTHER	WI	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	WI01E6	OTHER	WI	JOHN DEERE
3	39080723687	OTHER	WI	UNITY
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	12585	OTHER	WI	DEAN

General Provider Information

NPI Number	:	1104809839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA A HAYES PA

Provider Business Mailing Address
First Line	:	420 E DIVISION ST
Second Line	:
City	:	FOND DU LAC
State	:	WI
Zip	:	54935-4560
Country	:	US
Telephone Number	:	920-926-8340
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 E SHEBOYGAN ST
Second Line	:
City	:	CAMPBELLSPORT
State	:	WI
Zip	:	53010-2795
Country	:	US
Telephone Number	:	920-533-8361
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2005
Last Update Date	:	12/21/2020

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Directions to “ PATRICIA A HAYES PA” Practice Location

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