MEDICARE: DR. CREIGHTON GREGORY HEYL D.O..

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	003096	OH

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	791126347	OTHER	OH	MEDICARE RAILROAD

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	351497	OTHER	OH	WELLCARE
3	000000130736	OTHER	OH	ANTHEM
4	213866900	OTHER	OH	OH DEPT OF LABOR
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	3413456000027	OTHER	OH	CARESOURCE

NPI Number	:	1619971967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CREIGHTON GREGORY HEYL D.O..

Provider Business Mailing Address
First Line	:	26971 CHARDON RD
Second Line	:
City	:	RICHMOND HTS
State	:	OH
Zip	:	44143-1111
Country	:	US
Telephone Number	:	440-943-2086
Fax Number	:	440-943-5440

Provider Business Practice Location Address
First Line	:	26971 CHARDON RD
Second Line	:
City	:	RICHMOND HTS
State	:	OH
Zip	:	44143-1111
Country	:	US
Telephone Number	:	440-943-2086
Fax Number	:	440-943-5440

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	05/21/2008

26971 CHARDON RD
RICHMOND HTS, OH
44143-1111

Practice Phone: 440-943-2086
Practice Fax: 440-943-5440