Healthcare Provider Details

I. General information

NPI: 1942391784
Provider Name (Legal Business Name): BRIAN J HELLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 AIRPORT BLVD BLDG B
MOBILE AL
36608-6705
US

IV. Provider business mailing address

29653 ANCHOR CROSS BLVD
DAPHNE AL
36526-9594
US

V. Phone/Fax

Practice location:
  • Phone: 251-625-6896
  • Fax: 251-625-6897
Mailing address:
  • Phone: 251-625-6896
  • Fax: 251-625-6897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number28155
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number00028155
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number023686
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: