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Individual

DR. JEFFREY A HEAVILON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3600 W BETHEL AVE, MUNCIE, IN 47304-5407
(765) 284-7738
(765) 213-3713
Mailing address
PO BOX 1643, MUNCIE, IN 47308-1643
(765) 284-7738
(765) 213-3713

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01033655A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000087003
ANTHEM PIN
IN
05
100341090
IN
01
200018970
RAILROAD MEDICARE
IN
Enumeration date
07/31/2006
Last updated
01/22/2014
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