Individual
JOHNNY HYDE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5875 BREMO RD, MOB SOUTH, SUITE G-7, RICHMOND, VA 23226-1934
(804) 228-8900
(804) 282-9460
Mailing address
5875 BREMO RD, MOB SOUTH, SUITE G-7, RICHMOND, VA 23226-1934
(804) 228-8900
(804) 282-9460
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
0101239563
VA
207VX0201X
Gynecologic Oncology Physician
Primary
0101239563
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010266271
—
VA
01
—
10008181
OPTIMA
VA
01
—
C06778
GROUP PTAN
VA
01
—
P00360751
RAILROAD MEDICARE
VA
Enumeration date
01/19/2006
Last updated
03/07/2023
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