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Organization
KENNETH A HEILES, D.O. PLLC
Active
Organization
KENNETH A HEILES, D.O. PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH A HEILES D.O (OWNER/PHYSICIAN)
(870) 628-5110
Entity
Organization
Contact information
Practice address
203 S JEFFERSON ST, STAR CITY, AR 71667-5101
(870) 628-5110
(870) 628-5949
Mailing address
PO BOX 310, MOUNTAIN HOME, AR 72654-0310
(870) 628-5110
(870) 628-5949
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R3681
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112297003
—
AR
Enumeration date
05/04/2009
Last updated
09/28/2011
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