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NPI Code Detail

MEDICARE: MOSE SIM HAYES III MD

MEDICARE: MOSE SIM HAYES III MD
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
1207R00000XInternal Medicine PhysicianME109768FL
2207RH0003XHematology & Oncology PhysicianME109768FL

General Provider Information

NPI Number : 1720273949
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOSE SIM HAYES III MD
Provider Business Mailing Address
First Line : PO BOX 2699
Second Line :
City : PENSACOLA
State : FL
Zip : 32513-2699
Country : US
Telephone Number : 850-622-0873
Fax Number : 850-622-1912
Provider Business Practice Location Address
First Line : 27 MACK BAYOU LOOP
Second Line : SUITE 1000
City : SANTA ROSA BEACH
State : FL
Zip : 32459-2613
Country : US
Telephone Number : 850-622-0873
Fax Number : 850-622-1912
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2007
Last Update Date : 02/21/2014

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