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General NPI Number Information
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NPI Number | 1528030434
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Entity Type | Individual
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Provider Name | RICHARD R HEATH JR. MD
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Gender | Male
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Dates
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Enumeration Date | 02/03/2006
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Last Update Date | 11/17/2011
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Provider Practice Location Address
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Address Line | 417 W 3RD AVE
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City | ALBANY
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State | GA
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Zip | 31701-1943
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Country | US
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Telephone | 229-312-5133
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Fax | 229-312-5159
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Provider Business Mailing Address
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Address Line | PO BOX 2548
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City | ALBANY
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State | GA
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Zip | 31702-2548
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Country | US
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Telephone | 229-312-5800
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Fax | 229-312-5853
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 042842
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License Number State | GA
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