Healthcare Provider Details

I. General information

NPI: 1316251663
Provider Name (Legal Business Name): DAVID ROBERT HEINER M D P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2010
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 W HOSPITAL DR STE 8
PRICE UT
84501-4230
US

IV. Provider business mailing address

945 W HOSPITAL DR STE 8
PRICE UT
84501-4230
US

V. Phone/Fax

Practice location:
  • Phone: 435-637-7727
  • Fax:
Mailing address:
  • Phone: 435-637-7727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1683311205
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number1683311205
License Number StateUT

VIII. Authorized Official

Name: DR. DAVID ROBERT HEINER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 435-637-7727