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General NPI Number Information
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NPI Number | 1386655751
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Entity Type | Organization
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Legal Business Name | HEART OF GEORGIA WOMENS CENTER PC
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 04/13/2009
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Provider Practice Location Address
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Address Line | 209 GREEN STREET
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City | WARNER ROBINS
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State | GA
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Zip | 31093-1505
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Country | US
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Telephone | 478-328-3399
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Fax | 478-328-6455
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Provider Business Mailing Address
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Address Line | 209 GREEN ST
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City | WARNER ROBINS
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State | GA
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Zip | 31093-2727
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Country | US
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Telephone | 478-328-3399
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Fax | 478-328-6455
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Authorized Official
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Title or Position | OWNER
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Name | RICHARD L HEATON
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Credential | MD
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Telephone | 478-328-3399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 028927
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License Number State | GA
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