Individual
JOHN ALEX HEINTZELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
107 ROYAL BIRKDALE DR STE A, COLUMBIANA, OH 44408-8493
(330) 482-9350
(330) 482-2336
Mailing address
107 ROYAL BIRKDALE DR STE A, COLUMBIANA, OH 44408-8493
(330) 482-9350
(330) 482-2336
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35123178
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0106485
—
OH
01
—
H347380
MEDICARE PTAN
OH
Enumeration date
07/29/2011
Last updated
01/08/2024
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