Individual
DR. MATTHEW W HECKLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
7677 YANKEE ST, SUITE 110, CENTERVILLE, OH 45459-3475
(937) 428-0400
(937) 415-9191
Mailing address
PO BOX 713130, CINCINNATI, OH 45271-0001
(937) 415-9100
(937) 415-9191
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
9585
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3046448
—
OH
01
—
P00871995
RR MEDICARE
OH
Enumeration date
05/04/2007
Last updated
01/07/2011
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