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General NPI Number Information
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NPI Number | 1467696070
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Entity Type | Organization
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Legal Business Name | CHARLES F HYMAN O. D.
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Dates
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Enumeration Date | 04/27/2009
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Last Update Date | 06/23/2009
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Provider Practice Location Address
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Address Line | 1028 N MISSOURI ST STE 1
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City | WEST MEMPHIS
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State | AR
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Zip | 72301-2613
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Country | US
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Telephone | 870-735-8466
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Fax | 870-735-0717
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Provider Business Mailing Address
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Address Line | 1028 N MISSOURI ST STE 1
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City | WEST MEMPHIS
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State | AR
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Zip | 72301-2613
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Country | US
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Telephone | 870-735-8466
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Fax | 870-735-0717
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHARLES F HYMAN
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Credential | O. D.
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Telephone | 870-735-8466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 2249
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License Number State | AR
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