MEDICARE: CHAD N HEINEN M.D.

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
1	207R00000X	Internal Medicine Physician	E-3962	AR
2	207R00000X	Internal Medicine Physician	MD-023108	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	601880900	OTHER	AR	DEPARTMENT OF LABOR
2	710799061	OTHER	AR	CIGNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	5M807	OTHER	AR	BLUE CROSS BLUE SHIELD
5	710799061	OTHER	AR	TRICARE

General Provider Information

NPI Number	:	1629001490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAD N HEINEN M.D.

Provider Business Mailing Address
First Line	:	2027 SAINT JOSEPH AVE
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-5006
Country	:	US
Telephone Number	:	337-515-0027
Fax Number	:	888-336-6084

Provider Business Practice Location Address
First Line	:	2027 SAINT JOSEPH AVE
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-5006
Country	:	US
Telephone Number	:	337-515-0027
Fax Number	:	888-336-6084

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

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	06/19/2025

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