# MR. DONALD GARY HEACOCK

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1023022324
- **Gender:** Man
- **Credential:** P.T.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 15332 | MD | Yes |

## Other

- **Enumeration date:** 07/29/2006
- **Last updated:** 05/07/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1359660 | AETNA USHEALTHCARE | MD |
| 01 | — | 145799600 | OWCP/DEPARTMENT OF LABOR | MD |
| 01 | — | 147433401 | ACS / US DEPT OF LABOR | MD |
| 01 | — | 1784629 | UNITED HEALTHCARE | MD |
| 01 | — | 521200786 | UNITED HEALTH CARE | MD |
| 01 | — | 756LN288 | RAILROAD MEDICARE | MD |