Provider Demographics
NPI:1922543925
Name:HAYMAN MULTICARE
Entity Type:Organization
Organization Name:HAYMAN MULTICARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:928-776-9428
Mailing Address - Street 1:3103 CLEARWATER DR STE B
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-7165
Mailing Address - Country:US
Mailing Address - Phone:928-776-9428
Mailing Address - Fax:928-776-9214
Practice Address - Street 1:3103 CLEARWATER DR STE B
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305
Practice Address - Country:US
Practice Address - Phone:928-776-9428
Practice Address - Fax:928-776-9214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-29
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ216213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ102434Medicaid
AZ102434Medicaid
AZ6157070001Medicare NSC