Healthcare Provider Details

I. General information

NPI: 1326026964
Provider Name (Legal Business Name): ROBERT L HEYD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 E 31ST ST
KEARNEY NE
68847-2918
US

IV. Provider business mailing address

PO BOX 2435
KEARNEY NE
68848-2435
US

V. Phone/Fax

Practice location:
  • Phone: 308-234-5520
  • Fax: 308-236-6590
Mailing address:
  • Phone: 308-234-5520
  • Fax: 308-236-6590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number20672
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: