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General NPI Number Information
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NPI Number | 1750388245
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Entity Type | Individual
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Provider Name | LARRY E HEIT M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 03/09/2021
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Provider Practice Location Address
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Address Line | 11690 ALPHARETTA HWY
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City | ROSWELL
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State | GA
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Zip | 30076-3805
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Country | US
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Telephone | 770-475-5515
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Fax | 770-343-8884
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Provider Business Mailing Address
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Address Line | 5901 PEACHTREE DUNWOODY RD NE SUITE C-370
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City | ATLANTA
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State | GA
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Zip | 30328-5382
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Country | US
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Telephone | 678-892-2020
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Fax | 678-538-1950
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 041136
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License Number State | GA
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