Healthcare Provider Details

I. General information

NPI: 1477780799
Provider Name (Legal Business Name): ERIC ANTHONY HEIM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2009
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 N PARKVIEW DR
FAYETTEVILLE AR
72703-6398
US

IV. Provider business mailing address

3900 N PARKVIEW DR
FAYETTEVILLE AR
72703-6398
US

V. Phone/Fax

Practice location:
  • Phone: 479-966-4187
  • Fax: 479-966-4197
Mailing address:
  • Phone: 479-966-4187
  • Fax: 479-966-4197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberE-9297
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: