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NPI Code Detail

MEDICARE: DR. JAMES ANDREW HYDE MFT

MEDICARE: DR. JAMES ANDREW HYDE MFT
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
1106H00000XMarriage & Family TherapistKY0106KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1KY0106OTHERKYMFT

General Provider Information

NPI Number : 1619173820
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES ANDREW HYDE MFT
Provider Business Mailing Address
First Line : 1044 ALTA VISTA RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40205-1758
Country : US
Telephone Number : 502-992-9364
Fax Number : 502-895-1096
Provider Business Practice Location Address
First Line : 1044 ALTA VISTA RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40205-1758
Country : US
Telephone Number : 502-992-9364
Fax Number : 502-895-1096
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2007
Last Update Date : 07/08/2007

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Directions to “ DR. JAMES ANDREW HYDE MFT” Practice Location

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