Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 55239 | TN |
NPI | 1649258484 |
---|---|
Provider Name | Daniel Joseph Heintz |
First Address | Knoxville, TN 37901-5004 |
Second Address | Knoxville, TN 37916-3791 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2006 |
Last Update Date | 22/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I24658 | (02) | NV |
Q025838 | (05) | TN |