Healthcare Provider Details

I. General information

NPI: 1417901695
Provider Name (Legal Business Name): MICHAEL R. HEILIG, M.D., PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 09/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 SHOPPERS DRIVE
WINCHESTER KY
40391
US

IV. Provider business mailing address

404 SHOPPERS DRIVE
WINCHESTER KY
40391
US

V. Phone/Fax

Practice location:
  • Phone: 859-737-5333
  • Fax: 859-737-0070
Mailing address:
  • Phone: 859-737-5333
  • Fax: 859-737-0070

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 Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL R. HEILIG
Title or Position: OWNER
Credential: M.D.
Phone: 859-737-5333