Organization · Type 2 NPI

Samuel Hathy Iii,o.d.

Eyewear Supplier · Jacksonville, FL

NPI number 1801191960 Active

Practice location

11111 San Jose Blvd Ste 44
Jacksonville, FL 32223-7274

Call (904) 292-3976 Map

Fax (904) 292-5322

Mailing address

11111-44 San Jose Blvd
Jacksonville, FL 32223

Specialties and licenses

TaxonomyCodeLicense
Eyewear Supplier Primary 332H00000XFL-OPC-2361 (FL)

Eyewear Supplier: An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

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About NPI 1801191960

Samuel Hathy Iii,o.d.'s National Provider Identifier is 1801191960, issued on Jan 21, 2011. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Jacksonville, FL. The record was last updated on Jan 21, 2011.