Provider Demographics
NPI:1740236942
Name:HAYDEN, ANTHONY P (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:P
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 1:103 WIND HAVEN DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-8025
Mailing Address - Country:US
Mailing Address - Phone:800-646-4741
Mailing Address - Fax:859-223-2732
Practice Address - Street 1:1700 OLD LEBANON RD
Practice Address - Street 2:TAYLOR COUNTY HOSPITAL
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718-9662
Practice Address - Country:US
Practice Address - Phone:800-282-9221
Practice Address - Fax:859-223-2732
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY21736174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64217367Medicaid
KY64217367Medicaid
KY3377506Medicare ID - Type Unspecified