Provider Demographics
NPI:1225268758
Name:JAMES D. HEMMIG, O.D., P.A.
Entity Type:Organization
Organization Name:JAMES D. HEMMIG, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:HEMMIG
Authorized Official - Suffix:
Authorized Official - Credentials:OD, PA
Authorized Official - Phone:850-897-2020
Mailing Address - Street 1:4400 E HIGHWAY 20 STE 112
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-9735
Mailing Address - Country:US
Mailing Address - Phone:850-897-2020
Mailing Address - Fax:850-897-1064
Practice Address - Street 1:4400 E HIGHWAY 20 STE 112
Practice Address - Street 2:
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-9735
Practice Address - Country:US
Practice Address - Phone:850-897-2020
Practice Address - Fax:850-897-1064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-17
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC1840332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL078281500Medicaid
FL078281500Medicaid
FL0560740001Medicare NSC
FL19248Medicare PIN