Healthcare Provider Details

I. General information

NPI: 1043780133
Provider Name (Legal Business Name): HEILIG ORTHOPAEDICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2018
Last Update Date: 05/20/2022
Certification Date: 05/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 HIGHLAND PARK DR
RICHMOND KY
40475-3487
US

IV. Provider business mailing address

424 JETT DR
JACKSON KY
41339-9621
US

V. Phone/Fax

Practice location:
  • Phone: 859-353-4180
  • Fax: 859-878-1616
Mailing address:
  • Phone: 606-666-6607
  • Fax: 606-693-0535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL R HEILIG
Title or Position: OWNER
Credential: MD
Phone: 859-619-3368