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General NPI Number Information
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NPI Number | 1447319454
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Entity Type | Organization
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Legal Business Name | HECKER OPHTHALMOLOGY PA
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1507 WESTOVER TER STE C
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City | GREENSBORO
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State | NC
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Zip | 27408-7121
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Country | US
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Telephone | 336-274-7771
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Fax | 336-274-2024
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Provider Business Mailing Address
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Address Line | 1507 WESTOVER TER STE C
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City | GREENSBORO
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State | NC
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Zip | 27408-7121
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Country | US
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Telephone | 336-274-7771
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Fax | 336-274-2024
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Authorized Official
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Title or Position | OWNER
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Name | DR. KATHRYN J HECKER
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Credential | MD
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Telephone | 336-274-7771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 9700982
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License Number State | NC
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