Provider Demographics
NPI:1861422305
Name:HESTER, DEBORAH A (MD)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
Last Name:HESTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3294
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38803-3294
Mailing Address - Country:US
Mailing Address - Phone:662-377-4394
Mailing Address - Fax:662-377-7045
Practice Address - Street 1:25117 HIGHWAY 15
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:MS
Practice Address - Zip Code:39365-9088
Practice Address - Country:US
Practice Address - Phone:601-774-8214
Practice Address - Fax:601-774-5401
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS10442207P00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00010628Medicaid
E71120Medicare UPIN