MEDICARE: MICHELLE HEJNY O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	0618000563	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144298456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE HEJNY O.D.

Provider Business Mailing Address
First Line	:	2829 E OAKLAND AVE
Second Line	:	#1
City	:	JOHNSON CITY
State	:	TN
Zip	:	37601-1347
Country	:	US
Telephone Number	:	423-283-4590
Fax Number	:	423-283-0867

Provider Business Practice Location Address
First Line	:	500 GATE CITY HWY
Second Line	:	SPACE 405
City	:	BRISTOL
State	:	VA
Zip	:	24201-2372
Country	:	US
Telephone Number	:	276-466-6173
Fax Number	:	276-669-0570

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	03/24/2010

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Directions to “ MICHELLE HEJNY O.D.” Practice Location

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