Provider Demographics
NPI:1750658670
Name:HESTERS, JAMES EDWARD JR (HIS)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:EDWARD
Last Name:HESTERS
Suffix:JR
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1949 GA HIGHWAY 122
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31757-2500
Mailing Address - Country:US
Mailing Address - Phone:229-227-5905
Mailing Address - Fax:229-227-5906
Practice Address - Street 1:1949 GA HIGHWAY 122
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31757-2500
Practice Address - Country:US
Practice Address - Phone:229-227-5905
Practice Address - Fax:229-227-5906
Is Sole Proprietor?:No
Enumeration Date:2011-11-21
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA852237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist