Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 01075269A | IN |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 01075269A | IN |
NPI | 1679709133 |
---|---|
Provider Name | Dr. Brandon Jeffrey Hayes |
First Address | Indianapolis, IN 46250-2805 |
Second Address | Indianapolis, IN 46250-2041 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2009 |
Last Update Date | 12/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201293790 | (05) | IN |
P01588214 | RR MEDICARE (01) | IN |