Provider Demographics
NPI:1447221429
Name:HYLAND, JOHN A (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:HYLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3204 JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2354
Mailing Address - Country:US
Mailing Address - Phone:724-264-8700
Mailing Address - Fax:740-264-8796
Practice Address - Street 1:3204 JOHNSON RD
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2354
Practice Address - Country:US
Practice Address - Phone:724-264-8700
Practice Address - Fax:740-264-8796
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2020-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD055755L2085R0203X, 2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001881642Medicaid
WV3810002525Medicaid
OH2578045Medicaid
WV3810002525Medicaid
PA001881642Medicaid
PA045535Medicare PIN
OHHY4220531Medicare PIN