Provider Demographics
NPI:1366416083
Name:HAYES, MELINDA M (MD)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:M
Last Name:HAYES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7096
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95267-0096
Mailing Address - Country:US
Mailing Address - Phone:209-956-7725
Mailing Address - Fax:209-956-7733
Practice Address - Street 1:2735 SILVER CREEK RD.
Practice Address - Street 2:
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-7942
Practice Address - Country:US
Practice Address - Phone:928-763-2273
Practice Address - Fax:928-763-0223
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ31633207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ126083Medicare PIN
AZP00682093Medicare PIN
AZH95914Medicare UPIN