Healthcare Provider Details

I. General information

NPI: 1174964175
Provider Name (Legal Business Name): LAURA HEHN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA SPAULDING

II. Dates (important events)

Enumeration Date: 07/08/2013
Last Update Date: 09/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1061 HARMON AVE
FORT STEWART GA
31314-5674
US

IV. Provider business mailing address

1061 HARMON AVE
FORT STEWART GA
31314-5674
US

V. Phone/Fax

Practice location:
  • Phone: 912-435-6965
  • Fax:
Mailing address:
  • Phone: 912-435-6965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0116026335
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: