Provider Demographics
NPI:1225135577
Name:HAYDEN PHYSICAL THERAPY, P.C.
Entity Type:Organization
Organization Name:HAYDEN PHYSICAL THERAPY, P.C.
Other - Org Name:HAYDEN PHYSICAL THERAPY
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAYDEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:317-881-0101
Mailing Address - Street 1:586 S. STATE ROAD 135
Mailing Address - Street 2:SUITE E
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-1444
Mailing Address - Country:US
Mailing Address - Phone:317-881-0101
Mailing Address - Fax:317-881-6261
Practice Address - Street 1:586 S. STATE ROAD 135
Practice Address - Street 2:SUITE E
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-1444
Practice Address - Country:US
Practice Address - Phone:317-881-0101
Practice Address - Fax:317-881-6261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN53000079A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN231520Medicare ID - Type Unspecified