Provider Demographics
NPI:1588445001
Name:HAYES, FELICIA YVONNE (PHYSICIAN)
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:YVONNE
Last Name:HAYES
Suffix:
Gender:F
Credentials:PHYSICIAN
Other - Prefix:DR
Other - First Name:FELICIA
Other - Middle Name:YVONNE
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHYSICIAN/MEDICINE
Mailing Address - Street 1:3631 RIVER PARK DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40211-2918
Mailing Address - Country:US
Mailing Address - Phone:502-918-2091
Mailing Address - Fax:
Practice Address - Street 1:3631 RIVER PARK DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40211-2918
Practice Address - Country:US
Practice Address - Phone:502-918-2091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAJCFVQXXKXDC207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine