| Doctor Name: | BRUCE HAYSE |
| NPI Number: | 1154491579 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M. D. |
| License Number: | 3433A |
| Business Practice Address: | 269 West Broadway Jackson, WY - 830011884 |
| Business Phone Number: | 3077336700 |
| Business Fax Number: | 3077398890 |
| Mailing Address: | Po Box 1884, JACKSON |
| State: | WY |
| Postal Code: | 830011884 |
| Phone Number: | 3077336700 |
| Fax Number: | 3077398890 |
| NPI Enumeration Date: | 11/09/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 3433A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |