Provider Demographics
NPI:1316066970
Name:HAYES, CLELLA LOUISE (MD)
Entity type:Individual
Prefix:DR
First Name:CLELLA
Middle Name:LOUISE
Last Name:HAYES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CLELLA
Other - Middle Name:LOUISE
Other - Last Name:HAGANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:477 CAPP HARLAN RD
Mailing Address - Street 2:
Mailing Address - City:TOMPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42167-1808
Mailing Address - Country:US
Mailing Address - Phone:270-487-0701
Mailing Address - Fax:
Practice Address - Street 1:477 CAPP HARLAN RD
Practice Address - Street 2:
Practice Address - City:TOMPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42167-1808
Practice Address - Country:US
Practice Address - Phone:270-487-0701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYIP980207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine