Heidi Dearborn
General Practice Physician
1100 Wilford Hall Loop
Jbsa Lackland
, Texas 78236-5638
Heidi Dearborn
General Practice Physician
1100 Wilford Hall Loop
Jbsa Lackland
, Texas 78236-5638
(210) 292-5350
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About
Features
Specialties
- General Practice Physician
Languages spoken
- English
Location
First Address
- Heidi Dearborn
- 1100 Wilford Hall Loop
- Jbsa Lackland, TX
- Zip : 78236-5638
- Phone : (210) 292-5350
Second Address
- Heidi Dearborn
- 1100 Wilford Hall Loop
- Jbsa Lackland, TX
- Zip : 78236-5638
- Phone : (210) 292-5350
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208D00000X | General Practice Physician | DO2964 | ME |
National Provider Identifier
| NPI | 1003317744 |
|---|---|
| Provider Name | Heidi Dearborn |
| First Address | Jbsa Lackland, TX 78236-5638 |
| Second Address | Jbsa Lackland, TX 78236-5638 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/02/2018 |
| Last Update Date | 07/10/2019 |
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.