Provider Demographics
NPI:1619453206
Name:HAYES, VIRGIL C (DO,MSW)
Entity Type:Individual
Prefix:
First Name:VIRGIL
Middle Name:C
Last Name:HAYES
Suffix:
Gender:M
Credentials:DO,MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 LILLIAN AVE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-8050
Mailing Address - Country:US
Mailing Address - Phone:270-300-0092
Mailing Address - Fax:270-300-0092
Practice Address - Street 1:2321 WARDS RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-2101
Practice Address - Country:US
Practice Address - Phone:434-582-2273
Practice Address - Fax:434-582-1363
Is Sole Proprietor?:No
Enumeration Date:2018-07-17
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6071041C0700X
VA0116038484204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical