Individual
KELLEN HAYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2000 W BETHANY HOME RD, PHOENIX, AZ 85015-2443
(602) 246-5658
Mailing address
2000 W BETHANY HOME RD, PHOENIX, AZ 85015-2443
(602) 246-5658
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R75297
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
R75297
—
AZ
Enumeration date
06/24/2015
Last updated
06/24/2015
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