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General NPI Number Information
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NPI Number | 1871619627
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Entity Type | Organization
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Legal Business Name | PAUL F. HEYSE, MD, INC
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 07/24/2007
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Provider Practice Location Address
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Address Line | 4649 SCHRUBB DR
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City | KETTERING
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State | OH
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Zip | 45429-1984
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Country | US
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Telephone | 937-296-0300
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 714658
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City | COLUMBUS
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State | OH
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Zip | 43271-4658
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Country | US
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Telephone | 937-296-0300
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL F HEYSE
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Credential | DO
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Telephone | 937-296-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 043188
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License Number State | OH
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