Heinicke, Mark H
Heinicke, Mark H is an sole proprietor health care provider with primary practice located at 332 W Broadway Ste 217 , Louisville KY 40202-2114. He recently has only one registered license in Allopathic & Osteopathic Physicians / Rheumatology, which is considered as his primary health care specialty. Heinicke, Mark H can be contacted via phone (502) 589-2063.Contact Information
Primary practice address
332 W Broadway Ste 217
Louisville KY 40202-2114
Phone: (502) 589-2063
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Rheumatology | 207RR0500X | 21176 | Kentucky |
Profile Details
| NPI number | 1659400976 |
|---|---|
| LBN Legal business name | Heinicke, Mark H |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 4th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659400976 | NPPES |
| Kentucky | MEDICAID | 64211766 |
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