Provider Demographics
NPI:1811079411
Name:HAY, HERBY G JR (MD)
Entity type:Individual
Prefix:DR
First Name:HERBY
Middle Name:G
Last Name:HAY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HERB
Other - Middle Name:G
Other - Last Name:HAY
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5200 COMMERCE CROSSINGS DR FL 3
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40229-2182
Mailing Address - Country:US
Mailing Address - Phone:502-893-7462
Mailing Address - Fax:502-212-7550
Practice Address - Street 1:4003 KRESGE WAY STE 410
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4652
Practice Address - Country:US
Practice Address - Phone:502-893-7462
Practice Address - Fax:502-212-7550
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY26005207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200222650Medicaid
KY7393Medicare ID - Type Unspecified
KYE08929Medicare UPIN