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General NPI Number Information
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NPI Number | 1962471458
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Entity Type | Individual
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Provider Name | FRIEDRICH JOHANNES HEIBY O.D.
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Gender | Male
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 10/07/2014
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Provider Practice Location Address
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Address Line | 1038 MAPLE AVE
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City | ZANESVILLE
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State | OH
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Zip | 43701-3029
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Country | US
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Telephone | 740-453-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 2983 CENTER DR
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City | ZANESVILLE
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State | OH
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Zip | 43701-1430
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Country | US
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Telephone | 740-450-8100
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4936
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License Number State | OH
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