Provider Demographics
NPI:1518075597
Name:HAYES, JAMES A (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:HAYES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 CHESTER BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374
Mailing Address - Country:US
Mailing Address - Phone:765-966-7724
Mailing Address - Fax:765-966-7754
Practice Address - Street 1:1200 CHESTER BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374
Practice Address - Country:US
Practice Address - Phone:765-966-7724
Practice Address - Fax:765-966-7754
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01040361193400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes193400000XGroupSingle Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100320810AMedicaid
IN110058269OtherRAILROAD MEDICARE
IN000000083080OtherBCBS
IN000000083080OtherBCBS
IN100320810AMedicaid