Heacock, Alison

Heacock, Alison is an individual health care provider with primary practice located at 725 University Blvd , Beavercreek OH 45324-2640. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Heacock, Alison can be contacted via phone (937) 245-7100.

Contact Information

Primary practice address
725 University Blvd Beavercreek OH 45324-2640
Phone: (937) 245-7100
Fax: (937) 245-7999
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 25MP00322600 New Jersey
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 002939 Ohio

Profile Details

NPI number 1558306035
LBN Legal business name Heacock, Alison
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 18th, 2006
Last updated Mar 21st, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558306035 NPPES
Ohio MEDICAID 0072094

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