# HEATON FAMILY PRACTICE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154588499
- **Authorized official:** DR. FRED MATTHEW HEATON D.O. (MEMBER)
- **Authorized official phone:** (814) 224-2213

## Contact information

- **Practice address:** 100 NASON DR STE 103, ROARING SPRING, PA 16673-1201
- **Practice address phone:** (814) 224-2213
- **Practice address fax:** (814) 224-5879
- **Mailing address:** 100 NASON DR STE 103, ROARING SPRING, PA 16673-1201
- **Mailing address phone:** (814) 224-2213
- **Mailing address fax:** (814) 224-5879

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | OS013765 | PA | Yes |

## Other

- **Enumeration date:** 05/22/2008
- **Last updated:** 05/22/2008