Provider Demographics
NPI:1386680916
Name:HAYES, CAROL DEXTER (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROL DEXTER
Middle Name:
Last Name:HAYES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DEXTER
Other - Middle Name:
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:PAHALA
Mailing Address - State:HI
Mailing Address - Zip Code:96777-0040
Mailing Address - Country:US
Mailing Address - Phone:808-928-2027
Mailing Address - Fax:808-928-2030
Practice Address - Street 1:1 KAMANI STREET
Practice Address - Street 2:
Practice Address - City:PAHALA
Practice Address - State:HI
Practice Address - Zip Code:96777-0000
Practice Address - Country:US
Practice Address - Phone:808-928-2027
Practice Address - Fax:808-928-2930
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-15087207Q00000X
AZ20821207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI28117OtherHMSA
HI648850Medicaid
HIF73670Medicare UPIN