Provider Demographics
NPI:1730767211
Name:HYLE, THEODORE JOSEPH III
Entity type:Individual
Prefix:
First Name:THEODORE
Middle Name:JOSEPH
Last Name:HYLE
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10412 ZOCALO DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45251-1011
Mailing Address - Country:US
Mailing Address - Phone:513-560-0791
Mailing Address - Fax:
Practice Address - Street 1:10412 ZOCALO DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45251-1011
Practice Address - Country:US
Practice Address - Phone:513-560-0791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
3124958OtherOHIO DODD