Provider Demographics
NPI:1801899307
Name:HYDE, ARTHUR TOM (OD)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:TOM
Last Name:HYDE
Suffix:
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:PO BOX 1695
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37816-1695
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1760 W MORRIS BLVD
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-2834
Practice Address - Country:US
Practice Address - Phone:423-581-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD614152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0420430001OtherDMERC PROVIDER NUMBER
TN100022751OtherCARITEN AND PHP-TC
TN410036604OtherRAILROAD MEDICARE
TN6547874OtherCIGNA HEALTHCARE
TN4412131OtherAETNA
TN44595OtherBCBS PROVIDER NUMBER
TN0420430001OtherDMERC PROVIDER NUMBER
TN410036604OtherRAILROAD MEDICARE