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General NPI Number Information
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NPI Number | 1073717278
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Entity Type | Organization
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Legal Business Name | HESTER EYE ASSOCIATES, PC
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3745 CHEROKEE ST NW STE 404
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City | KENNESAW
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State | GA
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Zip | 30144-6733
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Country | US
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Telephone | 770-590-8191
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Fax | 770-590-8192
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Provider Business Mailing Address
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Address Line | 3745 CHEROKEE ST NW STE 404
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City | KENNESAW
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State | GA
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Zip | 30144-6733
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Country | US
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Telephone | 770-590-8191
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Fax | 770-590-8192
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK R HESTER
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Credential | OD
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Telephone | 770-590-8191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | GA1498
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License Number State | GA
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