Provider Demographics
NPI:1528187770
Name:HEY CLINIC, PA
Entity Type:Organization
Organization Name:HEY CLINIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:A
Authorized Official - Last Name:HEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MS
Authorized Official - Phone:919-790-1717
Mailing Address - Street 1:3320 WAKE FOREST RD STE 450
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7300
Mailing Address - Country:US
Mailing Address - Phone:919-790-1717
Mailing Address - Fax:919-926-1163
Practice Address - Street 1:3320 WAKE FOREST RD STE 450
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609
Practice Address - Country:US
Practice Address - Phone:919-790-1717
Practice Address - Fax:919-926-1163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
NC02358332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8941750Medicaid
NC8941750Medicaid
E777Medicare PIN