Provider Demographics
NPI:1154482560
Name:HAYES, COREY S (DMD)
Entity Type:Individual
Prefix:DR
First Name:COREY
Middle Name:S
Last Name:HAYES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 CURRY HWY
Mailing Address - Street 2:STE 108
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35503
Mailing Address - Country:US
Mailing Address - Phone:205-387-2122
Mailing Address - Fax:205-387-2124
Practice Address - Street 1:5100 CURRY HWY
Practice Address - Street 2:STE 108
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35503
Practice Address - Country:US
Practice Address - Phone:205-387-2122
Practice Address - Fax:205-387-2124
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL50491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
0118OtherUNITED CONCORDIA
AL97678OtherBCBS