Healthcare Provider Details

I. General information

NPI: 1659927788
Provider Name (Legal Business Name): TYLER PHARR HAMBY DOCTOR OF OPTOMETRY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2019
Last Update Date: 10/05/2022
Certification Date: 09/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4389 BEAUFORT ROAD
CHERRY POINT NC
28533
US

IV. Provider business mailing address

2910 JUDGE MANLY DR
NEW BERN NC
28562-9163
US

V. Phone/Fax

Practice location:
  • Phone: 205-516-7475
  • Fax:
Mailing address:
  • Phone: 205-516-7475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0618002751
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: