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NPI Code Detail

MEDICARE: BOBBY LEE HAYES

MEDICARE: BOBBY LEE HAYES
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
1146L00000XParamedic74360OK
2175T00000XPeer Specialist
3171M00000XCase Manager/Care Coordinator319437OK

General Provider Information

NPI Number : 1710664842
Entity Type Code : Individual
Provider Name (Legal Business Name) : BOBBY LEE HAYES
Provider Business Mailing Address
First Line : 21677 E HORSESHOE BEND RD
Second Line :
City : PARK HILL
State : OK
Zip : 74451-4133
Country : US
Telephone Number : 918-772-7499
Fax Number :
Provider Business Practice Location Address
First Line : 113 W KEETOOWAH ST
Second Line :
City : TAHLEQUAH
State : OK
Zip : 74464-3819
Country : US
Telephone Number : 918-931-3700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2023
Last Update Date : 01/22/2026

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