Provider Demographics
NPI:1013118462
Name:LEONARD J HAYS III MD PC
Entity Type:Organization
Organization Name:LEONARD J HAYS III MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAYS
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:423-622-0207
Mailing Address - Street 1:PO BOX 3470
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-0470
Mailing Address - Country:US
Mailing Address - Phone:423-622-0207
Mailing Address - Fax:423-697-6199
Practice Address - Street 1:2515 DESALES AVE STE 204
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-1100
Practice Address - Country:US
Practice Address - Phone:423-622-0207
Practice Address - Fax:423-697-6199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3730265Medicare ID - Type Unspecified