Healthcare Provider Details

I. General information

NPI: 1780637090
Provider Name (Legal Business Name): DARVIN LEE HEGE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150P PEACHFORD ROAD
ATLANTA GA
30338
US

IV. Provider business mailing address

2150P PEACHFORD ROAD
ATLANTA GA
30338
US

V. Phone/Fax

Practice location:
  • Phone: 770-458-0007
  • Fax: 770-452-1234
Mailing address:
  • Phone: 770-458-0007
  • Fax: 770-452-1234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number017757A
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number017757A
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: