Provider Demographics
NPI:1902810781
Name:HAYES, ANTHONY RODRIQUEZ (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:RODRIQUEZ
Last Name:HAYES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:336-475-7163
Mailing Address - Fax:336-475-1199
Practice Address - Street 1:903 RANDOLPH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-5898
Practice Address - Country:US
Practice Address - Phone:336-475-7163
Practice Address - Fax:336-475-1199
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC200500430207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5904521Medicaid
NC5904521Medicaid
NC2060109AMedicare PIN
BH9487302OtherFEDERAL DEA