Provider Demographics
NPI:1568460129
Name:HAYDEN, GREGORY L (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:L
Last Name:HAYDEN
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:PO BOX 722
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42419-0722
Mailing Address - Country:US
Mailing Address - Phone:812-477-3937
Mailing Address - Fax:812-477-9797
Practice Address - Street 1:3801 BELLEMEADE AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-0100
Practice Address - Country:US
Practice Address - Phone:812-477-3937
Practice Address - Fax:812-477-9797
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2014-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01043538207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000282959OtherBCBS
IN200143260Medicaid
KY64353493Medicaid
IN200143260Medicaid
IN000000282959OtherBCBS
KY64353493Medicaid