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Organization
HEINEN FAMILY MEDICINE
Active
Organization
HEINEN FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID P HEINEN MD (OWNER)
(337) 477-5988
Entity
Organization
Contact information
Practice address
3845 BROOKFLOWER CIRCLE LN, LAKE CHARLES, LA 70605-0292
(337) 477-5988
Mailing address
PO BOX 15, LAKE CHARLES, LA 70602-0015
(337) 477-5988
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053368
—
LA
01
—
4385507860
BCBS
LA
Enumeration date
05/02/2006
Last updated
06/15/2023
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