Healthcare Provider Details

I. General information

NPI: 1043282171
Provider Name (Legal Business Name): CAMDA MARIE HUGHEY OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAMDA MARIE TEMMEN

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

867 PEACHTREE ST NE STE 2
ATLANTA GA
30308-1902
US

IV. Provider business mailing address

1505 W MAIN ST
MT ZION IL
62549-1300
US

V. Phone/Fax

Practice location:
  • Phone: 470-823-4375
  • Fax: 678-949-9965
Mailing address:
  • Phone: 217-864-3221
  • Fax: 217-864-3345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046008630
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: