Provider Demographics
NPI:1255413621
Name:HAYES, CHRISTOPHER E (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:E
Last Name:HAYES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 S HILLSIDE ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67211-2128
Mailing Address - Country:US
Mailing Address - Phone:316-682-6551
Mailing Address - Fax:316-682-8151
Practice Address - Street 1:201 S HILLSIDE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67211-2128
Practice Address - Country:US
Practice Address - Phone:316-682-6551
Practice Address - Fax:316-682-8151
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-00750363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSP42188Medicare UPIN