Provider Demographics
NPI:1831448257
Name:HEDGES, JEFFREY GLEN (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:GLEN
Last Name:HEDGES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3519 WITHERSPOON BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6844
Mailing Address - Country:US
Mailing Address - Phone:919-401-1999
Mailing Address - Fax:
Practice Address - Street 1:3519 WITHERSPOON BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6844
Practice Address - Country:US
Practice Address - Phone:919-401-1999
Practice Address - Fax:919-401-1998
Is Sole Proprietor?:No
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4308111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor