Haysley, Jeremy Allen

Haysley, Jeremy Allen is an individual health care provider with primary practice located at 4881 Sugar Maple Dr 88 Medical Group/88 Sgc, Wright Patterson Afb OH 45433-5529. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Military Health Care Provider, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Haysley, Jeremy Allen can be contacted via phone (937) 257-0837.

Contact Information

Primary practice address
4881 Sugar Maple Dr 88 Medical Group/88 Sgc Wright Patterson Afb OH 45433-5529
Phone: (937) 257-0837
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Military Health Care Provider 171000000X
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 01088956A Indiana
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 52648 Kentucky
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 35.137187 Ohio

Profile Details

NPI number 1245658533
LBN Legal business name Haysley, Jeremy Allen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 3rd, 2014
Last updated Apr 11th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245658533 NPPES
Kentucky MEDICAID 7100362040

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