Provider Demographics
NPI:1538291356
Name:HAYES, JOSEPH M (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:M
Last Name:HAYES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 WASHINGTON AVE
Mailing Address - Street 2:SUITE 212
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-3636
Mailing Address - Country:US
Mailing Address - Phone:207-878-3030
Mailing Address - Fax:207-878-3211
Practice Address - Street 1:1321 WASHINGTON AVE
Practice Address - Street 2:SUITE 212
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-3636
Practice Address - Country:US
Practice Address - Phone:207-878-3030
Practice Address - Fax:207-878-3211
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1090111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME040515OtherANTHEM
MEMN0093OtherHARVARD PILGRIM
ME2290456OtherAETNA
ME216250000Medicaid
ME610886700OtherASC OWCP
ME216250000Medicaid
ME610886700OtherASC OWCP
MEMM8105Medicare PIN