Provider Demographics
NPI:1033959424
Name:HAYES, LUKE EDWYN
Entity type:Individual
Prefix:
First Name:LUKE
Middle Name:EDWYN
Last Name:HAYES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 S 600 E UNIT 1204
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-4381
Mailing Address - Country:US
Mailing Address - Phone:801-644-6863
Mailing Address - Fax:
Practice Address - Street 1:575 S 600 E UNIT 1204
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-4381
Practice Address - Country:US
Practice Address - Phone:801-644-6863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2023039312146M00000X
NV83947146M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate