Jack Heethouse is a Specialist in Michigan, Michigan. Jack Heethouse practices all healthcare services and medical treatments related to Specialist. The NPI Number for Jack Heethouse is 1679523674. The last update date is 2012-11-13.
Jack Heethouse's current location address is 1400 Mercy Dr., Michigan, Michigan. You can contact this provider via phone number 2317331326 and fax number 2317335212. The mailing address for Jack Heethouse is 1400 Mercy Dr., Michigan, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jack Heethouse |
|---|---|
| Address | 1400 Mercy Dr., Michigan, Michigan |
| Phone Number | 2317331326 |
| Fax Number | 2317335212 |
| Sole Proprietor | Y |
| Credentials | D.O. |
NPI Number Detail
| NPI Number | 1679523674 |
|---|---|
| Provider Enumeration Date | 2006-05-11 |
| Last Updated Date | 2012-11-13 |
Provider Mailing Address Detail
| Address | 1400 Mercy Dr. |
|---|---|
| City | Michigan |
| State | Michigan (MI) |
| Post Code | 49444 |
| Phone Number | 2317331326 |
| Fax Number | 2317335212 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 5101012999 |
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Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4308380 | MI | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Jack Heethouse by the Centers for Medicare & Medicaid Services?
The Jack Heethouse has been assigned the NPI (National Provider Identifier) 1679523674. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Jack Heethouse is geographically located?
The Jack Heethouse is physically situated at the following location: 1400 Mercy Dr., Michigan, MI, 49444.
What is Jack Heethouse's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Jack Heethouse is Specialist, and the taxonomy code that classifies this field of practice is 174400000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1679523674 to Jack Heethouse?
The Centers for Medicare & Medicaid Services assigned the 1679523674 to Jack Heethouse on 2006-05-11.
When was the information regarding Jack Heethouse most recently updated?
The details pertaining to the Jack Heethouse, including its address, specialty, and other relevant information, were last refreshed on 2012-11-13.