MEDICARE: DR. PAUL F HEYSE 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	208600000X	Surgery Physician	35043188	OH
2	2086S0129X	Vascular Surgery Physician	35043188H	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689676793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL F HEYSE M.D.

Provider Business Mailing Address
First Line	:	4649 SCHRUBB DR
Second Line	:
City	:	KETTERING
State	:	OH
Zip	:	45429-1984
Country	:	US
Telephone Number	:	937-296-0300
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 E APPLE ST STE 6252
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45409-2939
Country	:	US
Telephone Number	:	937-208-6060
Fax Number	:	937-208-6061

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	02/09/2012

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Directions to “ DR. PAUL F HEYSE M.D.” Practice Location

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