Dr. Larry L Heller
Internist - Addiction Medicine
430 E Division St
Fond du Lac
, Wisconsin 54935-4560
Dr. Larry L Heller
Internist - Addiction Medicine
430 E Division St
Fond du Lac
, Wisconsin 54935-4560
(920) 926-8343
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About
Features
Specialties
- Internist - Addiction Medicine
Languages spoken
- English
Location
First Address
- Dr. Larry L Heller
- 420 E Division St
- Fond Du Lac, WI
- Zip : 54935-4560
- Phone : (920) 926-8343
Second Address
- Dr. Larry L Heller
- 430 E Division St
- Fond Du Lac, WI
- Zip : 54935-4560
- Phone : (920) 926-4200
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RA0401X | Internist - Addiction Medicine | 18156 | WI |
National Provider Identifier
| NPI | 1285824029 |
|---|---|
| Provider Name | Dr. Larry L Heller |
| First Address | Fond Du Lac, WI 54935-4560 |
| Second Address | Fond Du Lac, WI 54935-4560 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/07/2007 |
| Last Update Date | 20/10/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 31081100 | (05) | WI |
| B 53526 | (02) | |
| BH 0423145 | DEA (01) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.