Provider Demographics
NPI:1073717278
Name:HESTER EYE ASSOCIATES, PC
Entity Type:Organization
Organization Name:HESTER EYE ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:R
Authorized Official - Last Name:HESTER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:770-590-8191
Mailing Address - Street 1:3745 CHEROKEE ST NW
Mailing Address - Street 2:STE 404
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-6733
Mailing Address - Country:US
Mailing Address - Phone:770-590-8191
Mailing Address - Fax:770-590-8192
Practice Address - Street 1:3745 CHEROKEE ST NW
Practice Address - Street 2:STE 404
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-6733
Practice Address - Country:US
Practice Address - Phone:770-590-8191
Practice Address - Fax:770-590-8192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA1498152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP4354Medicare ID - Type UnspecifiedMEDICARE