Provider Demographics
NPI:1356542765
Name:HEBBAR, HEMA JITENDRA (OD)
Entity type:Individual
Prefix:DR
First Name:HEMA
Middle Name:JITENDRA
Last Name:HEBBAR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:HEMA
Other - Middle Name:JITENDRA
Other - Last Name:CHAVDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:850 PIEDMONT AVE NE
Mailing Address - Street 2:UNIT 3309
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-1466
Mailing Address - Country:US
Mailing Address - Phone:404-610-7783
Mailing Address - Fax:404-870-5983
Practice Address - Street 1:200 GALLERIA PKWY SE
Practice Address - Street 2:SUITE 200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-5918
Practice Address - Country:US
Practice Address - Phone:770-955-3938
Practice Address - Fax:770-955-6706
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002131152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist