Provider Demographics
NPI:1346200839
Name:HAYES, GEORGE EDWARD (OD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:EDWARD
Last Name:HAYES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2321 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2860
Mailing Address - Country:US
Mailing Address - Phone:717-755-1828
Mailing Address - Fax:717-755-6215
Practice Address - Street 1:2321 E MARKET ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-2860
Practice Address - Country:US
Practice Address - Phone:717-755-1828
Practice Address - Fax:717-755-6215
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000517152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T27277Medicare UPIN
PA0476880002Medicare PIN
PA0476880001Medicare PIN