Provider Demographics
NPI:1447422134
Name:HAYES, ASHLEY L (D,D,S,)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:L
Last Name:HAYES
Suffix:
Gender:M
Credentials:D,D,S,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 567
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:TN
Mailing Address - Zip Code:37096-0567
Mailing Address - Country:US
Mailing Address - Phone:931-589-2515
Mailing Address - Fax:931-589-3783
Practice Address - Street 1:100 PERRY STREET
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:TN
Practice Address - Zip Code:37096-0567
Practice Address - Country:US
Practice Address - Phone:931-589-2515
Practice Address - Fax:931-589-3783
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN30121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3205914Medicaid