| Heaton Family Practice, Llc | |
|
100 Nason Dr Ste 103 Roaring Spring PA 16673-1201 | |
| (814) 224-2213 | |
| (814) 224-5879 |
| Full Name | Heaton Family Practice, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 100 Nason Dr Ste 103, Roaring Spring, Pennsylvania |
| Authorized Official Name and Position | Fred Matthew Heaton (MEMBER) |
| Authorized Official Contact | 8142242213 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heaton Family Practice, Llc 100 Nason Dr Ste 103 Roaring Spring PA 16673-1201 Ph: (814) 224-2213 | Heaton Family Practice, Llc 100 Nason Dr Ste 103 Roaring Spring PA 16673-1201 Ph: (814) 224-2213 |
| NPI Number | 1154588499 |
|---|---|
| Provider Enumeration Date | 05/22/2008 |
| Last Update Date | 05/22/2008 |
| Medicare PECOS PAC ID | 6406924513 |
|---|---|
| Medicare Enrollment ID | O20081002000337 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154588499 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS013765 (Pennsylvania) | Primary |
| Provider Name | Fred M Heaton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720039027 PECOS PAC ID: 2062580178 Enrollment ID: I20081002000324 |
| Provider Name | Allison L Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750945366 PECOS PAC ID: 3072856533 Enrollment ID: I20190524000418 |
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