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NPI Code Detail

MEDICARE: STEPHEN W HEIMBACH MD

MEDICARE: STEPHEN W HEIMBACH MD
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
1207L00000XAnesthesiology Physician18991OK

Other Identifiers

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

General Provider Information

NPI Number : 1780652339
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN W HEIMBACH MD
Provider Business Mailing Address
First Line : 1122 NE 13TH ST
Second Line : ORI 236
City : OKLAHOMA CITY
State : OK
Zip : 73117-1039
Country : US
Telephone Number : 405-271-1515
Fax Number :
Provider Business Practice Location Address
First Line : 750 NE 13TH ST
Second Line : SUITE 200, OKLAHOMA ALLERGY BUILDING
City : OKLAHOMA CITY
State : OK
Zip : 73104-5051
Country : US
Telephone Number : 405-271-4351
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2006
Last Update Date : 07/08/2007

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Directions to “ STEPHEN W HEIMBACH MD” Practice Location

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