Provider Demographics
NPI:1013355270
Name:HAYES, PATRICK KEVIN (DPH)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:KEVIN
Last Name:HAYES
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 S YALE AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74112-6216
Mailing Address - Country:US
Mailing Address - Phone:918-834-2864
Mailing Address - Fax:918-834-2869
Practice Address - Street 1:1424 S YALE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74112-6216
Practice Address - Country:US
Practice Address - Phone:918-834-2864
Practice Address - Fax:918-834-2869
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK10872183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist