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General NPI Number Information
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NPI Number | 1013123686
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Entity Type | Organization
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Legal Business Name | DAVID HEANEY, M.D., INC.
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 10/23/2007
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Provider Practice Location Address
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Address Line | 1070 N CHERRY ST
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City | TULARE
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State | CA
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Zip | 93274-2251
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Country | US
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Telephone | 559-733-9707
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Fax |
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Provider Business Mailing Address
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Address Line | 1120 N CHINOWTH ST
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City | VISALIA
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State | CA
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Zip | 93291-7896
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Country | US
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Telephone | 559-733-9707
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Fax |
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Authorized Official
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Title or Position | BOD: SECRETARY - ADMINISTRATOR
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Name | CHERYL BROOKSHER
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Credential |
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Telephone | 559-733-9707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 00A301420
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License Number State | CA
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