MEDICARE: VERNON J HAYES,D.O.,P.A.

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	207V00000X	Obstetrics & Gynecology Physician	E7973	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1050662T	OTHER	TX	COVENTRY HEALTH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	81X170	OTHER	TX	BLUE CROSS BLUE SHILED
4	0096QR	OTHER	TX	BLUE CROSS BLUE SHIELD
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811151525
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VERNON J HAYES,D.O.,P.A.

Provider Business Mailing Address
First Line	:	2600 MONTGOMERY ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-4525
Country	:	US
Telephone Number	:	817-731-3936
Fax Number	:	817-782-0206

Provider Business Practice Location Address
First Line	:	2600 MONTGOMERY ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-4525
Country	:	US
Telephone Number	:	817-731-3936
Fax Number	:	817-782-0206

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. VERNON J HAYES
Credential	:	D.O.
Telephone Number	:	817-731-3936

Provider Enumeration Date	:	07/11/2008
Last Update Date	:	07/14/2008

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