Provider Demographics
NPI:1588602387
Name:HAY, SAM HUTSON JR (MD)
Entity Type:Individual
Prefix:MR
First Name:SAM
Middle Name:HUTSON
Last Name:HAY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:310 CLINTON AVE W
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5527
Mailing Address - Country:US
Mailing Address - Phone:256-533-7330
Mailing Address - Fax:256-533-7306
Practice Address - Street 1:310 CLINTON AVE W
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5527
Practice Address - Country:US
Practice Address - Phone:256-533-7330
Practice Address - Fax:256-533-7306
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL5544207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000002789Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
ALC75179Medicare UPIN