=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376549469
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAVID S HEMMINGS M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/22/2005
-----------------------------------------------------
Last Update Date | 11/14/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6001 PROFESSIONAL PKWY SUITE 2040
-----------------------------------------------------
City | DOUGLASVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30134-5632
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-838-9999
-----------------------------------------------------
Fax | 678-838-9474
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6001 PROFESSIONAL PKWY SUITE 2040
-----------------------------------------------------
City | DOUGLASVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30134-5632
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-838-9999
-----------------------------------------------------
Fax | 678-838-9474
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number | 048152
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------