Provider Demographics
NPI:1164411880
Name:HAYS, LEONARD J III (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:J
Last Name:HAYS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1436 BROADRICK DR
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-3009
Mailing Address - Country:US
Mailing Address - Phone:706-226-3434
Mailing Address - Fax:706-226-4820
Practice Address - Street 1:1436 BROADRICK DR
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-3009
Practice Address - Country:US
Practice Address - Phone:706-226-3434
Practice Address - Fax:706-226-4820
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-14
Last Update Date:2024-01-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN24337207RC0000X
GA44744207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNC71691Medicare UPIN
TN1013118462Medicare PIN
TNDD5124Medicare UPIN
TN03730265Medicare PIN