Provider Demographics
NPI:1164425286
Name:HAYES, KIMBERLY W (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:W
Last Name:HAYES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-8702
Mailing Address - Country:US
Mailing Address - Phone:970-624-4420
Mailing Address - Fax:970-624-4459
Practice Address - Street 1:1136 E STUART ST
Practice Address - Street 2:STE 2100
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-1197
Practice Address - Country:US
Practice Address - Phone:970-493-5904
Practice Address - Fax:970-493-5973
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO42986207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO40230546Medicaid
COCOA103187Medicare PIN
COC51539Medicare UPIN
CO801168Medicare ID - Type Unspecified
CO40230546Medicaid