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General NPI Number Information
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NPI Number | 1548239064
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Entity Type | Individual
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Provider Name | CAROL A HEEBNER M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 11/01/2013
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Provider Practice Location Address
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Address Line | 120 W CHURCH ST STE. E
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City | BATESBURG-LEESVILLE
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State | SC
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Zip | 29006-2107
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Country | US
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Telephone | 803-532-2208
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Fax | 803-604-0207
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Provider Business Mailing Address
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Address Line | PO BOX 3788 SUITE 300
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City | COLUMBIA
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State | SC
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Zip | 29230-3788
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Country | US
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Telephone | 803-733-5969
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Fax | 803-217-0026
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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 | 16619
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License Number State | SC
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