Provider Demographics
NPI:1235175910
Name:HANLEY, R. HAYES JR (MD)
Entity Type:Individual
Prefix:
First Name:R.
Middle Name:HAYES
Last Name:HANLEY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 N WASHINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-1317
Mailing Address - Country:US
Mailing Address - Phone:804-798-9208
Mailing Address - Fax:804-798-8108
Practice Address - Street 1:635 N WASHINGTON HWY
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-1317
Practice Address - Country:US
Practice Address - Phone:804-798-9208
Practice Address - Fax:804-798-8108
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2010-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101027003207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC05704OtherGROUP PTAN
VA114642OtherANTHEM BCBS OF VA
VA254784OtherMAMSI
VA79175OtherSOUTHERN HEALTH SERVICES
VA110168787OtherRAILROAD MEDICARE
VA110168161OtherRAILROAD MEDICARE
VA4063436OtherAETNA LIFE
VA1533238OtherCIGNA
VA005811783Medicaid
VA45900OtherSENTARA
VA4063436OtherAETNA HMO
VA1533238OtherCIGNA