Healthcare Provider Details

I. General information

NPI: 1457647984
Provider Name (Legal Business Name): KEITH ANDREW HECK D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2011
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 PETERS RD STE 200-201
LITITZ PA
17543-7685
US

IV. Provider business mailing address

950 S OCTORARA TRL
PARKESBURG PA
19365-2100
US

V. Phone/Fax

Practice location:
  • Phone: 717-626-2167
  • Fax: 717-626-1915
Mailing address:
  • Phone: 609-680-7985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS017307
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberOS017307
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: