Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 08970 | AL |
NPI | 1073549168 |
---|---|
Provider Name | Louis W Heck JR. |
First Address | Birmingham, AL 35255-5310 |
Second Address | Birmingham, AL 35233 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 11/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000003817 | (05) | AL |
000003817 | BLUE CROSS (01) | AL |
000020402 | HEALTHSPRING OF ALABAMA (01) | AL |
C73457 | VIVA (01) | AL |