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General NPI Number Information
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NPI Number | 1366690026
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Entity Type | Organization
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Legal Business Name | WILLIAM F HECKERT D.O. P.C.
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Dates
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Enumeration Date | 09/05/2008
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Last Update Date | 09/05/2008
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Provider Practice Location Address
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Address Line | 2815 S PENNSYLVANIA AVE STE 107
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City | LANSING
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State | MI
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Zip | 48910-3496
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Country | US
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Telephone | 517-372-2253
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Fax | 517-372-2287
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Provider Business Mailing Address
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Address Line | 2815 S PENNSYLVANIA AVE STE 107
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City | LANSING
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State | MI
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Zip | 48910-3496
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Country | US
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Telephone | 517-372-2253
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Fax | 517-372-2287
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Authorized Official
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Title or Position | PRESEDENT
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Name | DR. WILLIAM HECKERT
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Credential | D.O.
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Telephone | 517-372-2253
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 5101006399
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License Number State | MI
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