MEDICARE: DR. KELLY HAYDEN HAYDAY 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
1	207Q00000X	Family Medicine Physician	2002002037	MO
2	207Q00000X	Family Medicine Physician	MD22056	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	113676284	OTHER	MO	TRICARE
2	60456	OTHER	MO	HEALTHCARE USA
3	177440	OTHER	MO	BLUE CROSS BLUE SHIELD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	506221704	OTHER	MO	MISSOURI CARE GRP
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	271769	OTHER	MO	GROUP HEALTH PLANS
8	5130576	OTHER	MO	CIGNA
9	H93927	OTHER	MO	MERCY
10	205123219	OTHER	MO	MISSOURI CARE IND
11	42835	OTHER	MO	HEALTHCARE USA GROUP
12	552798	OTHER	MO	HEALTHLINK

General Provider Information

NPI Number	:	1699746909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KELLY HAYDEN HAYDAY M.D.

Provider Business Mailing Address
First Line	:	1 MEDICAL CENTER DR
Second Line	:
City	:	BIDDEFORD
State	:	ME
Zip	:	04005-9422
Country	:	US
Telephone Number	:	207-467-8988
Fax Number	:	207-467-8969

Provider Business Practice Location Address
First Line	:	2 LIVEWELL DR
Second Line	:
City	:	KENNEBUNK
State	:	ME
Zip	:	04043-6762
Country	:	US
Telephone Number	:	207-467-8988
Fax Number	:	207-467-8969

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

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	12/02/2019

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