Provider Demographics
NPI:1992813554
Name:JOE D HESTER MD PA
Entity type:Organization
Organization Name:JOE D HESTER MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:DODD
Authorized Official - Last Name:HESTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-234-3937
Mailing Address - Street 1:PO BOX 460
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:AR
Mailing Address - Zip Code:71754-0460
Mailing Address - Country:US
Mailing Address - Phone:870-234-3937
Mailing Address - Fax:
Practice Address - Street 1:1700 PITTMAN ST.
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:AR
Practice Address - Zip Code:71753
Practice Address - Country:US
Practice Address - Phone:870-234-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC5403207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR113167002Medicaid
AR113167002Medicaid
AR523537499Medicare PIN