Provider Demographics
NPI:1558334144
Name:HEWITT, JIMMY II (DO)
Entity Type:Individual
Prefix:DR
First Name:JIMMY
Middle Name:
Last Name:HEWITT
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2510
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-2510
Mailing Address - Country:US
Mailing Address - Phone:706-922-8274
Mailing Address - Fax:706-922-6695
Practice Address - Street 1:105 E HUGH ST
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29841-2925
Practice Address - Country:US
Practice Address - Phone:803-279-6800
Practice Address - Fax:803-279-2876
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA065124207Q00000X
SCD01436207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDO1436OtherLICENSE
SCDO1436OtherLICENSE