Provider Demographics
NPI:1477888568
Name:HEDBERG, GINA MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:MARIE
Last Name:HEDBERG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:MARIE
Other - Last Name:SILVERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1236 MERLOT AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-4525
Mailing Address - Country:US
Mailing Address - Phone:320-224-0610
Mailing Address - Fax:
Practice Address - Street 1:707 GREENWOOD ST
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:OR
Practice Address - Zip Code:97448-1627
Practice Address - Country:US
Practice Address - Phone:541-998-6454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-07
Last Update Date:2013-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT831152W00000X
OR3404ATI152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist