1265578306 NPI number — DR ELOISE J HAYES PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265578306 NPI number — DR ELOISE J HAYES PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR ELOISE J HAYES PLLC
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:
1265578306
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1800 W 1ST ST
Provider Second Line Business Mailing Address:
SUITE 109
Provider Business Mailing Address City Name:
ELK CITY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73644-3133
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
580-225-3999
Provider Business Mailing Address Fax Number:
580-225-3979

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1800 W 1ST ST
Provider Second Line Business Practice Location Address:
SUITE 109
Provider Business Practice Location Address City Name:
ELK CITY
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73644-3133
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
580-225-3999
Provider Business Practice Location Address Fax Number:
580-225-3979
Provider Enumeration Date:
01/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HAYES
Authorized Official First Name:
ELOISE
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PHYSICIAN OWNER
Authorized Official Telephone Number:
580-225-3999

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  4474 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: DF7379 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( OK ) . This identifiers is of the category "OTHER".




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