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NPI Code Detail

MEDICARE: DR. JAMES FREEMAN HEISE M.D.

MEDICARE: DR. JAMES FREEMAN HEISE M.D.
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
1208M00000XHospitalist Physician46570-20WI
2207R00000XInternal Medicine Physician46570-020WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
146570OTHERWILICENSE

General Provider Information

NPI Number : 1316934060
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES FREEMAN HEISE M.D.
Provider Business Mailing Address
First Line : 323 S 18TH AVE
Second Line :
City : STURGEON BAY
State : WI
Zip : 54235-1401
Country : US
Telephone Number : 920-746-3680
Fax Number :
Provider Business Practice Location Address
First Line : 323 S 18TH AVE
Second Line :
City : STURGEON BAY
State : WI
Zip : 54235-1401
Country : US
Telephone Number : 920-743-5566
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2005
Last Update Date : 04/03/2025

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