Provider Demographics
NPI:1710219340
Name:HESTER AND MORRIS, LLC
Entity Type:Organization
Organization Name:HESTER AND MORRIS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARROLL
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:HESTER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:229-245-1800
Mailing Address - Street 1:3229 N OAK STREET EXT
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31605-6472
Mailing Address - Country:US
Mailing Address - Phone:229-245-1800
Mailing Address - Fax:229-245-0225
Practice Address - Street 1:3229 N OAK STREET EXTENSION
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31605-6472
Practice Address - Country:US
Practice Address - Phone:229-245-1800
Practice Address - Fax:229-245-0225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA9351302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization