Healthcare Provider Details

I. General information

NPI: 1316939879
Provider Name (Legal Business Name): WILLIAM F HEFNER O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 02/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SE 6TH AVE
TOPEKA KS
66603-3517
US

IV. Provider business mailing address

200 SE 6TH AVE
TOPEKA KS
66603-3517
US

V. Phone/Fax

Practice location:
  • Phone: 785-235-2374
  • Fax: 785-232-0136
Mailing address:
  • Phone: 785-235-2374
  • Fax: 785-232-0136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1479-3
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: