Provider Demographics
NPI:1003876582
Name:HYMAN, CHARLES FLOYD (OD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:FLOYD
Last Name:HYMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 N MISSOURI ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WEST MEMPHIS
Mailing Address - State:AR
Mailing Address - Zip Code:72301-2613
Mailing Address - Country:US
Mailing Address - Phone:870-735-8466
Mailing Address - Fax:870-735-0717
Practice Address - Street 1:1028 N MISSOURI ST
Practice Address - Street 2:SUITE 1
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-2613
Practice Address - Country:US
Practice Address - Phone:870-735-8466
Practice Address - Fax:870-735-0717
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2249152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR49065OtherBCBS
AR53000OtherSPECTERA
ART20270Medicare UPIN
AR49065Medicare PIN
AR49065OtherBCBS