Healthcare Provider Details

I. General information

NPI: 1801899307
Provider Name (Legal Business Name): ARTHUR TOM HYDE O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 12/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1760 W MORRIS BLVD
MORRISTOWN TN
37813-2834
US

IV. Provider business mailing address

PO BOX 1695
MORRISTOWN TN
37816-1695
US

V. Phone/Fax

Practice location:
  • Phone: 423-581-2020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOD614
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: