Organization
GREGORY D HEATON OD PA
Active
Other names
JAY VISION CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
ANGEL KELLEY (DELEGATED OFFICIAL)
(850) 675-0625
Entity
Organization
Contact information
Practice address
14088 ALABAMA ST, JAY, FL 32565-1036
(850) 675-0625
Mailing address
PO BOX 25, JAY, FL 32565-0025
(850) 675-0625
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC3531
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
621048100
—
FL
Enumeration date
12/19/2007
Last updated
06/15/2022
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