Individual
DR. KENNETH A HEILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
203 S JEFFERSON ST, STAR CITY, AR 71667-5101
(793) 229-5764
Mailing address
118 SEVEN HILLS DR, SPRING HILL, FL 34609-0235
(352) 666-6950
(352) 666-6438
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R3681
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112297003
—
AR
Enumeration date
06/22/2006
Last updated
07/12/2019
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