Provider Demographics
NPI:1487673422
Name:HAYES, DAVID JC (MD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JC
Last Name:HAYES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:235 SE NORTON LN STE A
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-8479
Mailing Address - Country:US
Mailing Address - Phone:503-472-4688
Mailing Address - Fax:503-474-4731
Practice Address - Street 1:235 SE NORTON LN STE A
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-8479
Practice Address - Country:US
Practice Address - Phone:503-472-4688
Practice Address - Fax:503-474-4731
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD26650207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR240014Medicaid
ORI62201Medicare UPIN
ORR135310Medicare PIN