Basic Information
| Provider Information | |||||||||
| NPI: | 1477661478 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HESTER | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | DEAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1100 REID PKWY | ||||||||
| Address2: | MEDICAL STAFF SERVICES | ||||||||
| City: | RICHMOND | ||||||||
| State: | IN | ||||||||
| PostalCode: | 473741157 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7659833127 | ||||||||
| FaxNumber: | 7659833219 | ||||||||
| Practice Location | |||||||||
| Address1: | 1350 CHESTER BLVD | ||||||||
| Address2: | SUITE A | ||||||||
| City: | RICHMOND | ||||||||
| State: | IN | ||||||||
| PostalCode: | 473741907 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7659358914 | ||||||||
| FaxNumber: | 7659838915 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2006 | ||||||||
| LastUpdateDate: | 04/26/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 01051908 | IN | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 000000083079 | 01 | IN | BCBS | OTHER | 000000606876 | 01 | IN | ANTHEM | OTHER | 0072863 | 05 | OH | MEDICAID | 110201174 | 01 | IN | RAILROAD MEDICARE | OTHER | 200242520 | 05 | IN | MEDICAID |