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NPI Code Detail

MEDICARE: TASSY N. HAYDEN M.D.

MEDICARE: TASSY N. HAYDEN 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
1207Q00000XFamily Medicine Physician248385MA
2207Q00000XFamily Medicine Physician2014021718MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22014021718OTHERMOMO STATE LICENSE

General Provider Information

NPI Number : 1871889303
Entity Type Code : Individual
Provider Name (Legal Business Name) : TASSY N. HAYDEN M.D.
Provider Business Mailing Address
First Line : 2340 HAMPTON AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63139-2935
Country : US
Telephone Number : 314-647-2200
Fax Number : 314-647-4172
Provider Business Practice Location Address
First Line : 2340 HAMPTON AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63139-2935
Country : US
Telephone Number : 314-647-2200
Fax Number : 314-647-4172
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2011
Last Update Date : 05/10/2018

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