Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 25763 | GA |
NPI | 1013026244 |
---|---|
Provider Name | Dr. Douglas P Hein |
First Address | Jesup, GA 31545-0244 |
Second Address | Jesup, GA 31545-0244 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 15/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00275569A | (05) | GA |
D40109 | (02) |