Provider Demographics
NPI:1386680916
Name:HAYES, CAROL DEXTER (MD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:DEXTER
Last Name:HAYES
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:DEXTER
Other - Middle Name:
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 10880
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86304-0880
Mailing Address - Country:US
Mailing Address - Phone:602-406-4786
Mailing Address - Fax:916-636-4358
Practice Address - Street 1:7700 E FLORENTINE RD STE 101
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-2245
Practice Address - Country:US
Practice Address - Phone:928-442-8710
Practice Address - Fax:916-636-4358
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-15087207Q00000X
AZ20821207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI648850Medicaid
HI28117OtherHMSA
AZ146599Medicaid