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General NPI Number Information
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NPI Number | 1841305331
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Entity Type | Individual
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Provider Name | LARRY K HEATH MD
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Gender | Male
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 08/02/2011
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Provider Practice Location Address
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Address Line | 493 BLACKWELL RD SUITE 101A
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City | WARRENTON
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State | VA
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Zip | 20186-2639
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Country | US
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Telephone | 540-316-4325
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Fax | 540-316-4331
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Provider Business Mailing Address
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Address Line | 136 LINDEN DR SUITE 104
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City | WINCHESTER
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State | VA
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Zip | 22601-6900
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Country | US
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Telephone | 540-678-3588
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Fax | 540-678-9025
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101243352
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 32455
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License Number State | WI
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