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NPI 1871565481

NPI 1871565481 : BRADLEY A HEIGES MD : SAVANNAH, GA

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General NPI Number Information
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    NPI Number           |    1871565481
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    Entity Type          |    Individual 
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    Provider Name        |    BRADLEY A HEIGES MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/07/2006
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    Last Update Date     |    10/23/2019
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Provider Practice Location Address
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    Address Line         |    210 E DERENNE AVE 
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    City                 |    SAVANNAH
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    State                |    GA
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    Zip                  |    31405-6736
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    Country              |    US
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    Telephone            |    912-644-5300
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    Fax                  |    912-644-5260
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Provider Business Mailing Address
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    Address Line         |    210 E DERENNE AVE 
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    City                 |    SAVANNAH
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    State                |    GA
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    Zip                  |    31405
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    Country              |    US
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    Telephone            |    912-644-5300
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    Fax                  |    912-644-5300
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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        |    207XS0117X
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    Taxonomy Name        |    Orthopaedic Surgery of the Spine Physician
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    License Number       |    050479
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    License Number State |    GA
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