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Individual
KEVIN T HEATON
Active
Individual
KEVIN T HEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
DO22887
OR
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
DO22887
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200046213
RAILROAD MEDICARE
OR
05
—
287483
—
OR
01
—
4604977397601
TRICARE
OR
01
—
831170000
BLUE CROSS
OR
01
—
XPY195175
MEDI-CAL
CA
Enumeration date
07/25/2006
Last updated
06/19/2024
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