Provider Demographics
NPI:1457487878
Name:HYATT, JOHN FEIOCK (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:FEIOCK
Last Name:HYATT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:JOHN
Other - Middle Name:MILTON
Other - Last Name:FEIOCK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:15620 MCGREGOR BL
Mailing Address - Street 2:SUITE F
Mailing Address - City:FT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-2528
Mailing Address - Country:US
Mailing Address - Phone:239-482-5900
Mailing Address - Fax:239-482-5989
Practice Address - Street 1:15620 MCGREGOR BL
Practice Address - Street 2:SUITE F
Practice Address - City:FT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-2528
Practice Address - Country:US
Practice Address - Phone:239-482-5900
Practice Address - Fax:239-482-5989
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN9509122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist