Provider Demographics
NPI:1093729188
Name:HAYDEN, MARLA JANAE (OD)
Entity Type:Individual
Prefix:DR
First Name:MARLA
Middle Name:JANAE
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:304 W COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381-1891
Mailing Address - Country:US
Mailing Address - Phone:810-593-0105
Mailing Address - Fax:
Practice Address - Street 1:4325 MILLER RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1216
Practice Address - Country:US
Practice Address - Phone:810-230-9292
Practice Address - Fax:810-230-7841
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004046152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU58427Medicare UPIN