Individual
RUSSELL W HYDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3600 NW SAMARITAN DR, CORVALLIS, OR 97330-5472
(541) 768-5111
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
5101025855
MI
208600000X
Surgery Physician
Primary
DO209456
OR
2086S0127X
Trauma Surgery Physician
5101025855
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
Other
Enumeration date
06/27/2012
Last updated
03/21/2022
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