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NPI Code Detail

MEDICARE: DR. THOMAS ELDON HAYHURST M.D.

MEDICARE:  DR. THOMAS ELDON HAYHURST  M.D.
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
1207RP1001XPulmonary Disease PhysicianIN01021495IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1IN01021495OTHERINSTATE MEDICAL LICENSE NO.

General Provider Information

NPI Number : 1316069164
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS ELDON HAYHURST M.D.
Provider Business Mailing Address
First Line : 200 E BERRY ST
Second Line : SUITE 360
City : FORT WAYNE
State : IN
Zip : 46802-2731
Country : US
Telephone Number : 260-449-7578
Fax Number :
Provider Business Practice Location Address
First Line : 4813 NEW HAVEN AVE
Second Line :
City : FORT WAYNE
State : IN
Zip : 46803-3018
Country : US
Telephone Number : 260-449-7920
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2007
Last Update Date : 02/10/2012

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Directions to “ DR. THOMAS ELDON HAYHURST M.D.” Practice Location

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