Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | ME49020 | FL |
NPI | 1477517233 |
---|---|
Provider Name | Richard David Heekin |
First Address | Jacksonville, FL 32204-4762 |
Second Address | Jacksonville, FL 32204-4753 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2006 |
Last Update Date | 29/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200041157 | RAILROAD MEDICARE (01) | FL |
421464000 | (05) | FL |
F35673 | (02) | FL |