Healthcare Provider Details

I. General information

NPI: 1669435731
Provider Name (Legal Business Name): SONJA ALEXANDRA HEUKER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 08/05/2021
Certification Date: 08/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3260 WESTBOURNE DR
CINCINNATI OH
45248-5107
US

IV. Provider business mailing address

PO BOX 636541
CINCINNATI OH
45263-6541
US

V. Phone/Fax

Practice location:
  • Phone: 513-674-1400
  • Fax: 513-206-1904
Mailing address:
  • Phone: 513-263-1532
  • Fax: 513-263-8622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number39062
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35086694
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: