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General NPI Number Information
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NPI Number | 1033377866
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Entity Type | Organization
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Legal Business Name | HEFFRON FAMILY EYE CARE, PLLC
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Dates
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Enumeration Date | 05/29/2008
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Last Update Date | 07/27/2015
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Provider Practice Location Address
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Address Line | 507 S L ROGERS WELLS BLVD SUITE E
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City | GLASGOW
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State | KY
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Zip | 42141-1043
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Country | US
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Telephone | 270-629-2015
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Fax | 270-629-2016
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Provider Business Mailing Address
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Address Line | 507 S L ROGERS WELLS BLVD SUITE E
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City | GLASGOW
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State | KY
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Zip | 42141-1043
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Country | US
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Telephone | 270-629-2015
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Fax | 270-629-2016
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMISON J HEFFRON
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Credential | O.D.
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Telephone | 270-629-2015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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