Provider Demographics
NPI:1740798313
Name:HAYES, DAVID LEE
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:LEE
Last Name:HAYES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2516 GALLATIN AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206-3216
Mailing Address - Country:US
Mailing Address - Phone:615-226-6320
Mailing Address - Fax:
Practice Address - Street 1:2516 GALLATIN AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37206-3216
Practice Address - Country:US
Practice Address - Phone:615-226-6320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-17
Last Update Date:2020-12-14
Deactivation Date:2019-12-09
Deactivation Code:
Reactivation Date:2020-12-07
Provider Licenses
StateLicense IDTaxonomies
TN43155183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist