Samuel Hathy III,O.D.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

FL-OPC-2361 Issued in FL

Legal business name

SAMUEL HATHY III,O.D.

Practice address

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

Phone

(904) 292-3976

Fax

(904) 292-5322

NPI assigned

Jan 21, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Samuel Hathy III, O.D.

Title

Doctor

Phone

(904) 292-3976

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Flora Chen Poveda, O.D.

  • Optometrist
  • Jacksonville, FL
  • NPI 1770625899
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1295568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295568000000",
    "number": "1801191960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11111-44 SAN JOSE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32223",
            "telephone_number": "904-292-3976",
            "fax_number": "904-292-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11111 SAN JOSE BLVD STE 44",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322237274",
            "telephone_number": "904-292-3976",
            "fax_number": "904-292-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL HATHY III,O.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-21",
        "last_updated": "2011-01-21",
        "status": "A",
        "authorized_official_last_name": "HATHY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "904-292-3976",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "FL",
            "license": "FL-OPC-2361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Woodville Sams II, M.D.
• Susan Leanne Samson, M.D.
• Samuel B. Gaskins IV DMD PA
• Samuel D Kulick DPM
• Samuel E. Myrick, Jr., M.D.
• Samuel Walters D.O.,P.a.
• Angelique Samuel, ARNP
• Ashleigh J Samuel
• Ashley Samuel, DPT
• Florence Gwendolyn Samuel

• Eyewear Supplier in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Eyewear Supplier in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.