Provider Demographics
NPI:1386803864
Name:HEDGES, DON W (DO)
Entity type:Individual
Prefix:
First Name:DON
Middle Name:W
Last Name:HEDGES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:6463 4TH ST NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-5810
Mailing Address - Country:US
Mailing Address - Phone:505-345-3572
Mailing Address - Fax:505-345-5889
Practice Address - Street 1:6463 4TH ST NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-5810
Practice Address - Country:US
Practice Address - Phone:505-345-3572
Practice Address - Fax:505-345-5889
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMA-624-74207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM42531Medicaid
NM2301888Medicare Oscar/Certification
NME15935Medicare UPIN