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General NPI Number Information
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NPI Number | 1144460296
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Entity Type | Individual
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Provider Name | ADAM JAMES HEISINGER D.O.
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Gender | Male
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Dates
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Enumeration Date | 03/03/2009
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 7300 SW CHILDS RD STE B
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City | TIGARD
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State | OR
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Zip | 97224-7772
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Country | US
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Telephone | 503-692-8700
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3290
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City | LA GRANDE
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State | OR
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Zip | 97850-7290
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Country | US
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Telephone | 541-963-8421
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Fax | 541-963-1476
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 58-002720
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 0102202485
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | DO187093
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License Number State | OR
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