Provider Demographics
NPI:1568669307
Name:JOHN A HYMAN OD PSC
Entity Type:Organization
Organization Name:JOHN A HYMAN OD PSC
Other - Org Name:DR. GARNERS VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ARNOLD
Authorized Official - Last Name:HYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:502-267-8261
Mailing Address - Street 1:9501 TAYLORSVILLE RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-2752
Mailing Address - Country:US
Mailing Address - Phone:502-267-8261
Mailing Address - Fax:502-267-4256
Practice Address - Street 1:9501 TAYLORSVILLE RD
Practice Address - Street 2:SUITE 106
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-2752
Practice Address - Country:US
Practice Address - Phone:502-267-8261
Practice Address - Fax:502-267-4256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY77009199Medicaid
KY2562Medicare PIN
KYT92257Medicare UPIN
KY77009199Medicaid