Individual
HAYDEN O JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
815 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2224
(817) 321-0387
(469) 522-6889
Mailing address
816 W CANNON ST, FORT WORTH, TX 76104-3146
(817) 321-0404
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0101054381
VA
2085R0202X
Diagnostic Radiology Physician
Primary
M8054
TX
2085R0202X
Diagnostic Radiology Physician
ME 113022
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121715004
—
TX
05
—
121715008
—
TX
05
—
285250101
—
TX
Enumeration date
01/20/2006
Last updated
04/28/2017
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us