=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265528657
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEARTLAND ANESTHESIA PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/05/2006
-----------------------------------------------------
Last Update Date | 10/29/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 120 S PARK DR
-----------------------------------------------------
City | BROWNWOOD
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76801-5918
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 325-641-1309
-----------------------------------------------------
Fax | 325-641-1310
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 2368
-----------------------------------------------------
City | BROWNWOOD
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76804-2368
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 325-641-1309
-----------------------------------------------------
Fax | 325-641-1310
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. LEONARD GAYLON NEPPER
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 325-641-1309
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207LP2900X
-----------------------------------------------------
Taxonomy Name | Pain Medicine (Anesthesiology) Physician
-----------------------------------------------------
License Number | J9240
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------