Hyde, Glen Dewayne
Hyde, Glen Dewayne is an individual health care provider with primary practice located at 12200 Ashford Dr , Yukon OK 73099-8762. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Hyde, Glen Dewayne can be contacted via phone (405) 283-9000.Contact Information
Primary practice address
12200 Ashford Dr
Yukon OK 73099-8762
Phone: (405) 283-9000
Fax: (405) 283-9025
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 20762 | Oklahoma |
Profile Details
| NPI number | 1912907056 |
|---|---|
| LBN Legal business name | Hyde, Glen Dewayne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 29th, 2005 |
| Last updated | Mar 21st, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912907056 | NPPES |
| Oklahoma | MEDICAID | 100096910D |
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