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NPI Code Detail

MEDICARE: PATRICK F HEATH OD

MEDICARE: PATRICK F HEATH OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist001281GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
352048528003OTHERGABCBS OF GA

General Provider Information

NPI Number : 1336231737
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICK F HEATH OD
Provider Business Mailing Address
First Line : 1140 13TH ST
Second Line :
City : COLUMBUS
State : GA
Zip : 31901-2204
Country : US
Telephone Number : 706-324-2073
Fax Number : 706-323-9435
Provider Business Practice Location Address
First Line : 1140 13TH ST
Second Line :
City : COLUMBUS
State : GA
Zip : 31901-2204
Country : US
Telephone Number : 706-324-2073
Fax Number : 706-323-9435
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2006
Last Update Date : 01/11/2012

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