1528244712 NPI number — HAYES ENDOCRINE & DIABETES CENTER, PC

Table of content: GENEVA DE MARZO RDN, LD (NPI 1780395020)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528244712 NPI number — HAYES ENDOCRINE & DIABETES CENTER, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HAYES ENDOCRINE & DIABETES CENTER, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528244712
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/05/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 28TH AVE N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37209-4001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 28TH AVE N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37209-4001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-320-1620
Provider Business Practice Location Address Fax Number:
615-327-0643
Provider Enumeration Date:
01/17/2008

Additional Information

Authorized Official

Authorized Official Last Name:
HAYES
Authorized Official First Name:
ANDREA
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
615-324-1949

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  MD25278 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3814950 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3814950 . This is a "MEDICARE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com