Provider Demographics
NPI:1104840115
Name:POWELL, HAYDEN EVANS (OD)
Entity Type:Individual
Prefix:DR
First Name:HAYDEN
Middle Name:EVANS
Last Name:POWELL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2612 APOLLO CIR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35226-2305
Mailing Address - Country:US
Mailing Address - Phone:205-915-0959
Mailing Address - Fax:205-444-0317
Practice Address - Street 1:5561 GROVE BLVD
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226-4600
Practice Address - Country:US
Practice Address - Phone:205-987-6759
Practice Address - Fax:205-444-0317
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALSA93TA669152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist