Provider Demographics
NPI:1083681498
Name:HAYES, JOSEPH LAWRENCE JR (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:LAWRENCE
Last Name:HAYES
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4900 CALIFORNIA AVE STE 400B
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-7081
Mailing Address - Country:US
Mailing Address - Phone:661-459-1000
Mailing Address - Fax:661-459-1974
Practice Address - Street 1:4900 CALIFORNIA AVE STE 400B
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-7081
Practice Address - Country:US
Practice Address - Phone:661-459-1900
Practice Address - Fax:661-459-1944
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A16344207RS0012X, 208000000X, 207R00000X, 2080S0012X
NY1592242080S0012X, 207RS0012X
AZ005783207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080S0012XAllopathic & Osteopathic PhysiciansPediatricsSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
11170OtherMOHAWK VALLEY PHYS HP
C59422OtherAMERICAN PROGRESSIVE LIFE
NY01041152Medicaid
159224OtherTRICARE
26142OtherMOHAWK VALLEY PHYS HP
000442128002OtherBLUE SHIELD OF NENY
060201000031OtherFIDELIS CARE NEW YORK
294AQ2OtherEMPIRE BLUE CROSS
RA6503OtherFIDELIS MEDICARE
10000861OtherCDPHP
NO FAULTOther159224
159224OtherWORKERS COMP
202428710OtherCIGNA
JH0294AQ20OtherEMPIRE BLUE CROSS
JH0294AQ20OtherEMPIRE BLUE CROSS
C59422Medicare UPIN
RA6503Medicare ID - Type Unspecified