# CHARLES R. HERON, M.D., S.C.

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

## Provider details

- **NPI number:** 1427005107
- **Authorized official:** CHARLES R HERON M.D. (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (920) 498-4200

## Contact information

- **Practice address:** 1726 SHAWANO AVE, GREEN BAY, WI 54303-3216
- **Practice address phone:** (920) 498-4200
- **Mailing address:** 225 S EXECUTIVE DR, BROOKFIELD, WI 53005-4266
- **Mailing address phone:** (262) 787-4026

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | — |
| 207L00000X | Anesthesiology Physician | — | — | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/28/2006
- **Last updated:** 09/11/2025