Provider Demographics
NPI:1801868021
Name:HAYES, JOHN MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:MICHAEL
Last Name:HAYES
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 1:3401 SPRINGHILL DR
Mailing Address - Street 2:STE 400
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117
Mailing Address - Country:US
Mailing Address - Phone:501-945-4422
Mailing Address - Fax:501-945-4424
Practice Address - Street 1:3401 SPRINGHILL DR
Practice Address - Street 2:STE 400
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117
Practice Address - Country:US
Practice Address - Phone:501-945-4422
Practice Address - Fax:501-955-6046
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARN8073208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR118945001Medicaid
54497Medicare ID - Type Unspecified
E50409Medicare UPIN