Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 35054373 | OH |
Y | 111NI0900X | Internist | 35054373 | OH |
N | 208000000X | Pediatrician | 35054373 | OH |
N | 2080P0214X | Pediatric Pulmonologist | 35054373 | OH |
NPI | 1255323440 |
---|---|
Provider Name | John Stephen Heintz |
First Address | Columbus, OH 43215-1056 |
Second Address | Columbus, OH 43205-2664 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 23/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0652842 | (05) | OH |
E29802 | (02) |