Organization
KENNETH J HAYLES MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH J HAYLES M.D. (OWNER PRESIDENT)
(662) 335-6010
Entity
Organization
Contact information
Practice address
1550 MEDICAL PARK 1, GREENVILLE, MS 38703-7239
(662) 335-6010
(662) 335-6208
Mailing address
1550 MEDICAL PARK 1, GREENVILLE, MS 38703-7239
(662) 335-6010
(662) 335-6208
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
09714
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126774
—
MS
Enumeration date
10/12/2006
Last updated
08/02/2007
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