Provider Demographics
NPI:1679576342
Name:HAYES, TANYA M (MD)
Entity Type:Individual
Prefix:DR
First Name:TANYA
Middle Name:M
Last Name:HAYES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1700 OLD LEBANON RD
Mailing Address - Street 2:
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42718-9615
Mailing Address - Country:US
Mailing Address - Phone:270-247-8100
Mailing Address - Fax:270-247-7780
Practice Address - Street 1:1700 OLD LEBANON RD
Practice Address - Street 2:
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718
Practice Address - Country:US
Practice Address - Phone:270-789-6082
Practice Address - Fax:270-789-6080
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY38233207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64095359Medicaid
KYD88677Medicare UPIN
KY1318605Medicare PIN