Provider Demographics
NPI:1235134669
Name:HAYES, LANEAU (MD)
Entity type:Individual
Prefix:DR
First Name:LANEAU
Middle Name:
Last Name:HAYES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 326
Mailing Address - Street 2:
Mailing Address - City:HIAWASSEE
Mailing Address - State:GA
Mailing Address - Zip Code:30546-0326
Mailing Address - Country:US
Mailing Address - Phone:706-835-5000
Mailing Address - Fax:706-379-1215
Practice Address - Street 1:986 OLD CHICKEN FARM RD
Practice Address - Street 2:
Practice Address - City:YOUNG HARRIS
Practice Address - State:GA
Practice Address - Zip Code:30582-2122
Practice Address - Country:US
Practice Address - Phone:706-835-5000
Practice Address - Fax:706-379-1215
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA023366207R00000X
NC35363207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00259531IMedicaid
NC890574UMedicaid
NC2238490AMedicare ID - Type Unspecified
GA00259531IMedicaid
NC890574UMedicaid