Heacock, James K

Heacock, James K is an individual health care provider with primary practice located at 1640 Highway 88 Suite 203, Brick NJ 08724-3036. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Heacock, James K can be contacted via phone (732) 458-7777.

Contact Information

Primary practice address
1640 Highway 88 Suite 203 Brick NJ 08724-3036
Fax: (732) 263-9470
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MA03492800 New Jersey

Profile Details

NPI number 1992778153
LBN Legal business name Heacock, James K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 8th, 2006
Last updated Apr 24th, 2013 - about 11 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 1992778153 NPPES
New Jersey Other 1K8145 HEALTHNET
New Jersey Other 110172482 HEALTHNET
New Jersey Other 223360408-010 HEALTHNET
New Jersey Other P1043622 HEALTHNET
New Jersey MEDICAID 4745809 HEALTHNET

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