Provider Demographics
NPI:1336328467
Name:HAYES, JOHN DAVID (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:DAVID
Last Name:HAYES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3100 MACCORKLE AVE SE
Mailing Address - Street 2:STE 203
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1228
Mailing Address - Country:US
Mailing Address - Phone:304-388-1724
Mailing Address - Fax:304-388-1721
Practice Address - Street 1:210 BROOKS ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1855
Practice Address - Country:US
Practice Address - Phone:304-388-1930
Practice Address - Fax:304-388-1929
Is Sole Proprietor?:No
Enumeration Date:2007-10-25
Last Update Date:2017-02-14
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Provider Licenses
StateLicense IDTaxonomies
WV245742086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVWV0467AMedicare PIN