Provider Demographics
NPI:1477589463
Name:HAYS, ROBERT B (PA-C)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:B
Last Name:HAYS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 HAYS BLVD.
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:286 US HIGHWAY 23 N
Practice Address - Street 2:SUITE 102
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-8732
Practice Address - Country:US
Practice Address - Phone:606-874-0032
Practice Address - Fax:606-874-0064
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA532363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY95002143Medicaid
KY95002143Medicaid
P29970Medicare UPIN