Provider Demographics
NPI:1316389455
Name:HEDGES, JAMES KENNETH (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KENNETH
Last Name:HEDGES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 NOAHS STAR ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-8609
Mailing Address - Country:US
Mailing Address - Phone:702-256-8791
Mailing Address - Fax:
Practice Address - Street 1:805 NOAHS STAR ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-8609
Practice Address - Country:US
Practice Address - Phone:702-256-8791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01018344A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology