Organization
HYDE PROSTHETICS AND ORTHOTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD LAMAR HYDE (OWNER)
(478) 474-8040
Entity
Organization
Contact information
Practice address
130 COLLEGE ST, MACON, GA 31201-1607
(478) 474-8040
(478) 474-8048
Mailing address
130 COLLEGE ST, MACON, GA 31201-1607
(478) 474-8040
(478) 474-8048
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
GA
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003107963A
—
GA
05
—
003209255A
—
GA
Enumeration date
07/18/2011
Last updated
08/27/2019
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