Provider Demographics
NPI:1558591495
Name:KARL HYDE MD PC
Entity Type:Organization
Organization Name:KARL HYDE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KARL
Authorized Official - Middle Name:G
Authorized Official - Last Name:HYDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-999-5679
Mailing Address - Street 1:PO BOX 3024
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-0298
Mailing Address - Country:US
Mailing Address - Phone:518-561-1603
Mailing Address - Fax:518-561-0179
Practice Address - Street 1:1445 STATE ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-4248
Practice Address - Country:US
Practice Address - Phone:503-566-6507
Practice Address - Fax:503-581-4405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-24
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty