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NPI Code Detail

MEDICARE: DR. STEVEN PAUL HEAP OD

MEDICARE:  DR. STEVEN PAUL HEAP  OD
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
1152W00000XOptometrist523AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
25219420001OTHERAZDMERC SUPPLIER

General Provider Information

NPI Number : 1255326864
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEVEN PAUL HEAP OD
Provider Business Mailing Address
First Line : 39 E 1ST STREET
Second Line :
City : EAGAR
State : AZ
Zip : 85925-9664
Country : US
Telephone Number : 928-333-4396
Fax Number : 928-333-5050
Provider Business Practice Location Address
First Line : 39 E 1ST STREET
Second Line :
City : EAGAR
State : AZ
Zip : 85925-9664
Country : US
Telephone Number : 928-333-4396
Fax Number : 928-333-5050
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2005
Last Update Date : 10/10/2008

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Directions to “ DR. STEVEN PAUL HEAP OD” Practice Location

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