Individual
DR. THOMAS ELDON HAYHURST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4813 NEW HAVEN AVE, FORT WAYNE, IN 46803-3018
(260) 449-7920
Mailing address
200 E BERRY ST, SUITE 360, FORT WAYNE, IN 46802-2731
(260) 449-7578
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
IN01021495
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IN01021495
STATE MEDICAL LICENSE NO.
IN
Enumeration date
04/04/2007
Last updated
02/10/2012
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