Provider Demographics
NPI:1164582045
Name:HAYES, JOSEPH C
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:C
Last Name:HAYES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RT 1 BOX 149
Mailing Address - Street 2:
Mailing Address - City:CUSTER CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73639
Mailing Address - Country:US
Mailing Address - Phone:580-593-2990
Mailing Address - Fax:580-593-2991
Practice Address - Street 1:RT 1 BOX 149
Practice Address - Street 2:
Practice Address - City:CUSTER CITY
Practice Address - State:OK
Practice Address - Zip Code:73639
Practice Address - Country:US
Practice Address - Phone:580-593-2990
Practice Address - Fax:580-593-2991
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies