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General NPI Number Information
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NPI Number | 1417978107
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Entity Type | Individual
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Provider Name | ALISON R HEFFERNAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 07/10/2009
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Provider Practice Location Address
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Address Line | 10700 MONTGOMERY RD SUITE 100
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City | CINCINNATI
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State | OH
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Zip | 45242-3255
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Country | US
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Telephone | 513-984-5552
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Fax | 513-984-5552
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Provider Business Mailing Address
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Address Line | 10700 MONTGOMERY RD SUITE 100
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City | CINCINNATI
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State | OH
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Zip | 45242-3255
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Country | US
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Telephone | 513-984-5552
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Fax | 513-984-5552
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 43664
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD.026395
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 35.093625
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License Number State | OH
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