Provider Demographics
NPI:1437560976
Name:ROBERT F HESTER PHD, LLC
Entity Type:Organization
Organization Name:ROBERT F HESTER PHD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-264-0073
Mailing Address - Street 1:PO BOX 18919
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39404-8919
Mailing Address - Country:US
Mailing Address - Phone:601-264-0073
Mailing Address - Fax:601-264-2620
Practice Address - Street 1:7 WOODSTONE PLZ
Practice Address - Street 2:STE 5
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-7508
Practice Address - Country:US
Practice Address - Phone:601-264-0073
Practice Address - Fax:601-264-2620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS18194103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1295757870OtherSINGLE ENTITY NPI
MS680000110Medicare PIN