Provider Demographics
NPI:1447219977
Name:TUHY, EDWIN JR (OD)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:
Last Name:TUHY
Suffix:JR
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 1:2615 ALMOND ST
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-1176
Mailing Address - Country:US
Mailing Address - Phone:541-883-3688
Mailing Address - Fax:541-883-3687
Practice Address - Street 1:2640 BIEHN ST
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-1181
Practice Address - Country:US
Practice Address - Phone:541-884-3148
Practice Address - Fax:541-884-3373
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2714AT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORXSD000820OtherMEDI-CAL
ORA006OtherTRICARE
OR004571006OtherBCBS
OR295420Medicaid
OR410038543OtherRAILROAD MEDICARE
OR295420Medicaid
OR0447820001Medicare NSC
ORXSD000820OtherMEDI-CAL
OR0447820002Medicare NSC