Provider Demographics
NPI:1760040125
Name:HESS, JUSTIN POWELL (MD)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:POWELL
Last Name:HESS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1364 WESTGATE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-2932
Mailing Address - Country:US
Mailing Address - Phone:336-768-4140
Mailing Address - Fax:336-768-4487
Practice Address - Street 1:1364 WESTGATE CENTER DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-2932
Practice Address - Country:US
Practice Address - Phone:336-768-4140
Practice Address - Fax:336-768-4487
Is Sole Proprietor?:No
Enumeration Date:2019-05-31
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2023-00110207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology