Provider Demographics
NPI:1922069731
Name:HAYES, ROBY F (MD)
Entity Type:Individual
Prefix:
First Name:ROBY
Middle Name:F
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 1:10000 SE MAIN ST STE 327
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216-2470
Mailing Address - Country:US
Mailing Address - Phone:503-256-5866
Mailing Address - Fax:503-254-0656
Practice Address - Street 1:10000 SE MAIN ST STE 327
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-2470
Practice Address - Country:US
Practice Address - Phone:503-256-1575
Practice Address - Fax:503-253-9848
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD17311208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR027800Medicaid
00WCGMRFMedicare ID - Type Unspecified
OR027800Medicaid