Provider Demographics
NPI:1326135765
Name:HAYDEN, ROBERT ALAN (DC, PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALAN
Last Name:HAYDEN
Suffix:
Gender:M
Credentials:DC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 ROCK ST
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-4235
Mailing Address - Country:US
Mailing Address - Phone:770-412-0005
Mailing Address - Fax:
Practice Address - Street 1:210 ROCK ST
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-4235
Practice Address - Country:US
Practice Address - Phone:770-412-0005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR005426GA111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU58580Medicare UPIN