Charles R. Heron, M.D., S.C.
LBN: Charles R. Heron, M.D., S.C.
Charles R. Heron, M.D., S.C. is an health care organization with primary practice located at 1726 Shawano Ave , Green Bay WI 54303-3216. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Anesthesiology is the primary health care specialty.
Charles R. Heron, M.D., S.C. can be contacted via phone (920) 498-4200, or through Heron, Charles R via phone (920) 498-4200.
Contact Information
Primary practice address
1726 Shawano Ave
Green Bay WI 54303-3216
Phone: (920) 498-4200
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | ||
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X |
Profile Details
| NPI number | 1427005107 |
|---|---|
| LBN Legal business name | Charles R. Heron, M.D., S.C. |
| DBA Doing business as | |
| Authorized official | Heron, Charles R Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 28th, 2006 |
| Last updated | Aug 22nd, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427005107 | NPPES |
| Wisconsin | MEDICAID | 32081000 |
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