Healthcare Provider Details

I. General information

NPI: 1508950411
Provider Name (Legal Business Name): TIMOTHY E HECKARD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 12/21/2025
Certification Date: 12/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 N 5TH ST
MIDDLETOWN IN
47356-1008
US

IV. Provider business mailing address

2015 JACKSON ST HEALTH NETWORK OF MADISON COUNTY
ANDERSON IN
46016-4337
US

V. Phone/Fax

Practice location:
  • Phone: 765-354-2062
  • Fax: 765-354-4679
Mailing address:
  • Phone: 765-683-3136
  • Fax: 765-683-3170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35-069469
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01052202A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: