Provider Demographics
NPI:1790778769
Name:HAYTER, RONALD G (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:G
Last Name:HAYTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1799 N BELCHER RD STE B
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-1324
Mailing Address - Country:US
Mailing Address - Phone:727-953-9492
Mailing Address - Fax:866-954-2553
Practice Address - Street 1:1799 N BELCHER RD STE B
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-1324
Practice Address - Country:US
Practice Address - Phone:727-953-9492
Practice Address - Fax:866-954-2553
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-25
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0058632207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL372802100Medicaid
FL11566Medicare PIN
C02928Medicare UPIN