MEDICARE: MR. STEVEN T HEATH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN287517	GA

General Provider Information

NPI Number	:	1235943879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEVEN T HEATH

Provider Business Mailing Address
First Line	:	116 SPARROW ST
Second Line	:
City	:	PERRY
State	:	GA
Zip	:	31069-9201
Country	:	US
Telephone Number	:	478-365-1462
Fax Number	:

Provider Business Practice Location Address
First Line	:	116 SPARROW ST
Second Line	:
City	:	PERRY
State	:	GA
Zip	:	31069-9201
Country	:	US
Telephone Number	:	478-365-1462
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2025
Last Update Date	:	06/13/2025

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Directions to “ MR. STEVEN T HEATH ” Practice Location

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