| Doctor Name: | KENNETH E HYDE |
| NPI Number: | 1164503264 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | |
| Business Practice Address: | 9040 Reid St # A Attn: Credentials) Joint Base Lewis Mcchord, WA - 984315037 |
| Business Phone Number: | 2539681250 |
| Business Fax Number: | 2539682550 |
| Mailing Address: | 9040 Reid St # A, Attn: Credentials) JOINT BASE LEWIS MCCHORD |
| State: | WA |
| Postal Code: | 984315037 |
| Phone Number: | 2539681250 |
| Fax Number: | 2539682550 |
| NPI Enumeration Date: | 10/17/2006 |
| NPI Last Update Date: | 11/30/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |