Individual
LAWRENCE T. HYDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
200 W LORAIN ST, OBERLIN, OH 44074-1026
(440) 775-1211
Mailing address
PO BOX 65274, CHARLOTTE, NC 28265-0274
(800) 377-8721
(304) 523-2241
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2291
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000381861
BLUECROSS BLUESHIELD
OH
Enumeration date
03/10/2006
Last updated
09/14/2007
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