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NPI Code Detail

MEDICARE: DR. CHARLES PATRICK HECKMAN O.D.

MEDICARE: DR. CHARLES PATRICK HECKMAN O.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
1152W00000XOptometrist18002366IN

General Provider Information

NPI Number : 1326143165
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES PATRICK HECKMAN O.D.
Provider Business Mailing Address
First Line : 1280 BLACK OAK DR
Second Line :
City : GREENWOOD
State : IN
Zip : 46143-3121
Country : US
Telephone Number : 317-882-7083
Fax Number :
Provider Business Practice Location Address
First Line : 2125 N MORTON ST
Second Line :
City : FRANKLIN
State : IN
Zip : 46131-9624
Country : US
Telephone Number : 317-736-0159
Fax Number : 317-736-0334
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2006
Last Update Date : 07/08/2007

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