Provider Demographics
NPI:1013026244
Name:HEIN, DOUGLAS P (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:P
Last Name:HEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:320 PEACHTREE ST
Mailing Address - Street 2:
Mailing Address - City:JESUP
Mailing Address - State:GA
Mailing Address - Zip Code:31545-0244
Mailing Address - Country:US
Mailing Address - Phone:912-427-7790
Mailing Address - Fax:912-427-7707
Practice Address - Street 1:330 PEACHTREE ST
Practice Address - Street 2:SUITE 2
Practice Address - City:JESUP
Practice Address - State:GA
Practice Address - Zip Code:31545-0244
Practice Address - Country:US
Practice Address - Phone:912-427-6915
Practice Address - Fax:912-427-4455
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA25763207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00275569AMedicaid
GA00275569AMedicaid