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General NPI Number Information
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NPI Number | 1548389455
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Entity Type | Individual
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Provider Name | ANDREW DUNSMORE HEINZELMANN MD
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Gender | Male
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 05/17/2023
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Provider Practice Location Address
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Address Line | 3317 N WIMBERLY DR
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-4056
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Country | US
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Telephone | 479-521-2752
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Fax | 479-444-6942
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Provider Business Mailing Address
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Address Line | 3317 N WIMBERLY DR
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-4056
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Country | US
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Telephone | 479-587-3149
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Fax | 479-521-4603
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | E-4659
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 19708
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | E-4659
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License Number State | AR
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