Provider Demographics
NPI:1619905718
Name:HEMMIG, JAMES (OD PA)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:HEMMIG
Suffix:
Gender:M
Credentials:OD PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 HIGHWAY 20 EAST
Mailing Address - Street 2:SUITE 112
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-9735
Mailing Address - Country:US
Mailing Address - Phone:850-897-4941
Mailing Address - Fax:850-897-1064
Practice Address - Street 1:4400 HIGHWAY 20 EAST
Practice Address - Street 2:SUITE 112
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-9735
Practice Address - Country:US
Practice Address - Phone:850-897-4941
Practice Address - Fax:850-897-1064
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 1840152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL19248ZOtherINDIVIDUAL PTAN NUMBER
FL1619905718OtherINDIVIDUAL NPI NUMBER
FL0560740001OtherMEDICARE DMEPOS PTAN
FL078281500Medicaid
FLEH918AMedicare PIN
FLT84182Medicare UPIN
FL078281500Medicaid