Provider Demographics
NPI:1609800325
Name:HAYES, LOUISE ANNETTE (MD)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:ANNETTE
Last Name:HAYES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 TRAILWOOD DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-5008
Mailing Address - Country:US
Mailing Address - Phone:330-726-3000
Mailing Address - Fax:330-726-2612
Practice Address - Street 1:901 TRAILWOOD DR
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-5008
Practice Address - Country:US
Practice Address - Phone:330-726-3000
Practice Address - Fax:330-726-2612
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35052423208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1200547OtherUNITED HEALTHCARE
OH78237OtherHEALTH ASSURANCE
OHZ52423OtherSUMMACARE
OH000000243201OtherANTHEM BC/BS
OH341341025027OtherCARESOURCE
OH0632006Medicaid
OHQ022844OtherHOMETOWN
OH0632006Medicaid
OHHA0785274Medicare PIN