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Individual

DR. JOEL THOMAS HEITMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
615 S NEW BALLAS RD DEPT OF, SAINT LOUIS, MO 63141-8221
(314) 251-6031
Mailing address
150 BERTRAND DR, FRANKLIN, TN 37064-8308
(810) 964-1892

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
01074617A
IN
2085R0202X
Diagnostic Radiology Physician
Primary
2019042401
MO
2085R0202X
Diagnostic Radiology Physician
35125154
OH
2085R0202X
Diagnostic Radiology Physician
4301095035
MI
2085R0202X
Diagnostic Radiology Physician
47753
KY
2085R0202X
Diagnostic Radiology Physician
52155
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0112227
OH
05
1164656559
MI
05
201255510
IN
05
7100328740
KY
05
Q012331
TN
Enumeration date
05/13/2009
Last updated
08/18/2020
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