| Gary Heaston, PA-C | |
|
7238 6th St, Jensen Occupational Medicine Center, Bldg. 249, Hill Air Force Base, UT 84056-5213 | |
| (801) 777-1157 | |
| Not Available |
| Full Name | Gary Heaston |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 7238 6th St, Hill Air Force Base, Utah |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083672992 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 324779-1206 (Utah) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Gary Heaston, PA-C Jensen Occupational Medical Center, 7238 6th St. Bldg 249, Hill Air Force Base, UT 84056-5213 Ph: (801) 777-1157 | Gary Heaston, PA-C 7238 6th St, Jensen Occupational Medicine Center, Bldg. 249, Hill Air Force Base, UT 84056-5213 Ph: (801) 777-1157 |
Mr. Rickie E. Johnson, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 7238 6th St Bldg 249, Hill Air Force Base, UT 84056 Phone: 801-777-1155 Fax: 801-775-6884 |