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General NPI Number Information
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NPI Number | 1891946232
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Entity Type | Organization
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Legal Business Name | ALAN HEAP, M.D., P.C.
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Dates
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Enumeration Date | 10/03/2008
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Last Update Date | 10/03/2008
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Provider Practice Location Address
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Address Line | 185 N MAIN ST SUITE 601
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City | TOOELE
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State | UT
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Zip | 84074-2161
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Country | US
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Telephone | 435-882-2207
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Fax | 435-882-2247
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Provider Business Mailing Address
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Address Line | PO BOX 633
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City | TOOELE
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State | UT
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Zip | 84074-0633
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Country | US
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Telephone | 801-352-9500
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Fax | 801-352-9502
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Authorized Official
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Title or Position | OWNER
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Name | ALAN FRANKLIN HEAP
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Credential | MD
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Telephone | 435-882-2207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 171179-1205
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License Number State | UT
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