Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NX0800X | Chiropractor Orthopedic Specialist | 591 | MA |
Y | 207Q00000X | Family Doctor | MD220028 | PA |
N | 207Q00000X | Family Doctor | MT220028 | PA |
NPI | 1457376808 |
---|---|
Provider Name | Dr. John Paul Hayes JR. |
First Address | Easton, PA 18045-5670 |
Second Address | Easton, PA 18045-5670 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 06/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
591 | LICENSE (01) | MA |