Organization
SAMUEL HATHY III,O.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL HATHY III O.D. (DOCTOR)
(904) 292-3976
Entity
Organization
Contact information
Practice address
11111 SAN JOSE BLVD STE 44, JACKSONVILLE, FL 32223-7274
(904) 292-3976
(904) 292-5322
Mailing address
11111-44 SAN JOSE BLVD, JACKSONVILLE, FL 32223
(904) 292-3976
(904) 292-5322
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
FL-OPC-2361
FL
Other
Enumeration date
01/21/2011
Last updated
01/21/2011
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