MEDICARE: ELIZABETH H HYDE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	3234	AL

General Provider Information

NPI Number	:	1558995605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH H HYDE

Provider Business Mailing Address
First Line	:	200 ONE NINETEEN BLVD
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35242-7236
Country	:	US
Telephone Number	:	205-745-4600
Fax Number	:	317-884-3388

Provider Business Practice Location Address
First Line	:	200 ONE NINETEEN BLVD
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35242-7236
Country	:	US
Telephone Number	:	205-745-4600
Fax Number	:	317-884-3388

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2020
Last Update Date	:	02/27/2020

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Directions to “ ELIZABETH H HYDE ” Practice Location

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