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General NPI Number Information
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NPI Number | 1598123457
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Entity Type | Individual
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Provider Name | JEFFREY TODD HEDGES PA-C
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Gender | Male
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Dates
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Enumeration Date | 02/08/2016
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 1002 N CHURCH ST STE 100
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City | GREENSBORO
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State | NC
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Zip | 27401-1447
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Country | US
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Telephone | 336-580-5157
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Fax |
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Provider Business Mailing Address
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Address Line | 400 PINELLAS ST STE 325
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City | CLEARWATER
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State | FL
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Zip | 33756-3320
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Country | US
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Telephone | 727-298-6121
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Fax | 727-298-6151
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9113430
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA9113430
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-06254
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License Number State | NC
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