Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 1024918 | IN |
NPI | 1033117619 |
---|---|
Provider Name | James M. Heinrich |
First Address | Evansville, IN 47715-8198 |
Second Address | Evansville, IN 47715-8198 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2005 |
Last Update Date | 27/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000108304 | ANTHEM (01) | IN |
100242370A | (05) | IN |
181210 | HEALTHLINK (01) | IN |
200009402 | RR MEDICARE (01) | IN |
D95043 | (02) | IN |