Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 69475 | GA |
NPI | 1033172648 |
---|---|
Provider Name | Dr. Edward Elam Hayes |
First Address | Dublin, GA 31021-2557 |
Second Address | Dublin, GA 31021-2557 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2006 |
Last Update Date | 27/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003137861A | (05) | GA |
562251157 | TAX ID (01) |