1891946232 NPI number — ALAN HEAP, M.D., P.C.

Table of content: (NPI 1891946232)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891946232 NPI number — ALAN HEAP, M.D., P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALAN HEAP, M.D., P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ALAN F HEAP, MD
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891946232
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/03/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 633
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOOELE
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84074-0633
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-352-9500
Provider Business Mailing Address Fax Number:
801-352-9502

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
185 N MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 601
Provider Business Practice Location Address City Name:
TOOELE
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84074-2161
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
435-882-2207
Provider Business Practice Location Address Fax Number:
435-882-2247
Provider Enumeration Date:
10/03/2008

Additional Information

Authorized Official

Authorized Official Last Name:
HEAP
Authorized Official First Name:
ALAN
Authorized Official Middle Name:
FRANKLIN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
435-882-2207

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  171179-1205 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1730279605 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com