Healthcare Provider Details

I. General information

NPI: 1558334144
Provider Name (Legal Business Name): JIMMY HEWITT II D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 E HUGH ST
NORTH AUGUSTA SC
29841-2925
US

IV. Provider business mailing address

PO BOX 2510
EVANS GA
30809-2510
US

V. Phone/Fax

Practice location:
  • Phone: 803-279-6800
  • Fax: 803-279-2876
Mailing address:
  • Phone: 706-922-8274
  • Fax: 706-922-8251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number065124
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD01436
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: