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General NPI Number Information
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NPI Number | 1861710089
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Entity Type | Individual
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Provider Name | IAN MICHAEL HESTER CAA
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Gender | Male
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Dates
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Enumeration Date | 05/12/2010
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 777 HEMLOCK ST
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City | MACON
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State | GA
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Zip | 31201-2102
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Country | US
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Telephone | 478-633-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 901 18TH ST E
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City | TIFTON
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State | GA
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Zip | 31794-3648
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Country | US
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Telephone | 229-382-7120
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Fax |
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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 | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number | ANT-0000046
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number | 2022036871
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number | 10980
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License Number State | GA
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