Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 29163 | NE |
Y | 111NI0900X | Internist | 29163 | NE |
N | 208D00000X | General Practice Physician | 29163 | NE |
NPI | 1003229014 |
---|---|
Provider Name | Dr. Eric Heppner |
First Address | Tripler Amc, HI 96859-5001 |
Second Address | Fort Hood, TX 76544-5060 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2014 |
Last Update Date | 01/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
VAD000 | (02) | |
VAD000 | UPIN (01) | HI |