Provider Demographics
NPI:1467431890
Name:HAYES, ROBERT C (OD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:C
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:PO BOX 376
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:AL
Mailing Address - Zip Code:35043-0376
Mailing Address - Country:US
Mailing Address - Phone:205-678-2020
Mailing Address - Fax:205-678-2021
Practice Address - Street 1:16233 HIGHWAY 280
Practice Address - Street 2:SUITE C
Practice Address - City:CHELSEA
Practice Address - State:AL
Practice Address - Zip Code:35043-8301
Practice Address - Country:US
Practice Address - Phone:205-678-2020
Practice Address - Fax:205-678-2021
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-683-TA-175152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL2210080OtherUNITED HEALTHCARE
ALOT41014OtherMEDICARE COMPLETE
AL924628OtherBLOCK VISION PROVIDER NUM
AL1019620001OtherPALMETTO GOVERNMENT
AL58430OtherBLUE CROSS BLUE SHEILD
AL00058430Medicaid
AL00058430Medicaid
ALOT41014OtherMEDICARE COMPLETE
AL58430OtherBLUE CROSS BLUE SHEILD