Provider Demographics
NPI:1265408603
Name:HAYDEN, STEVEN MARK (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:MARK
Last Name:HAYDEN
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 1:76297 TALLASSEE HWY
Mailing Address - Street 2:
Mailing Address - City:WETUMPKA
Mailing Address - State:AL
Mailing Address - Zip Code:36092-5558
Mailing Address - Country:US
Mailing Address - Phone:334-514-1910
Mailing Address - Fax:
Practice Address - Street 1:76297 TALLASSEE HWY
Practice Address - Street 2:
Practice Address - City:WETUMPKA
Practice Address - State:AL
Practice Address - Zip Code:36092-5558
Practice Address - Country:US
Practice Address - Phone:334-514-1910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-26
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13468207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL81290Medicare ID - Type UnspecifiedMEDICARE