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General NPI Number Information
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NPI Number | 1245404037
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Entity Type | Organization
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Legal Business Name | STACEY C. HEIT, M.D., P.C.
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Dates
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Enumeration Date | 04/14/2008
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Last Update Date | 04/14/2008
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Provider Practice Location Address
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Address Line | 11755 POINTE PL SUITE A1
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City | ROSWELL
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State | GA
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Zip | 30076-4636
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Country | US
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Telephone | 678-613-4745
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Fax | 770-667-2238
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Provider Business Mailing Address
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Address Line | 11755 POINTE PL SUITE A1
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City | ROSWELL
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State | GA
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Zip | 30076-4636
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Country | US
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Telephone | 678-613-4745
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Fax | 770-667-2238
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Authorized Official
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Title or Position | OWNER
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Name | DR. STACEY CATHLEEN HEIT
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Credential | M.D.
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Telephone | 678-613-4745
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 41307
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License Number State | GA
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