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General NPI Number Information
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NPI Number | 1043588312
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Entity Type | Individual
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Provider Name | TODD HERON MS, PA-C
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Gender | Male
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Dates
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Enumeration Date | 12/01/2011
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 1159 EAGLE DR
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City | LOVELAND
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State | CO
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Zip | 80537-8020
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Country | US
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Telephone | 970-219-5223
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Fax | 970-449-1606
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Provider Business Mailing Address
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Address Line | PO BOX 360301
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City | PITTSBURGH
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State | PA
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Zip | 15251-6301
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Country | US
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Telephone | 844-969-0686
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Fax | 773-832-7083
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.0003357
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License Number State | CO
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