Provider Demographics
NPI:1174770259
Name:HAYDEN, SCOTT CHARLES (DC)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:CHARLES
Last Name:HAYDEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:SCOTT
Other - Middle Name:CHARLES
Other - Last Name:HAYDEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:3 PLAINFIELD ST
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082-5813
Mailing Address - Country:US
Mailing Address - Phone:860-995-5486
Mailing Address - Fax:
Practice Address - Street 1:3 PLAINFIELD ST
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-5813
Practice Address - Country:US
Practice Address - Phone:860-995-5486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001756111N00000X
MA3204111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor