Individual
JAKE P HEINEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7640 SYLVANIA AVE, SUITE B, SYLVANIA, OH 43560-9729
(419) 517-7533
(419) 517-7502
Mailing address
7640 SYLVANIA AVE STE B, SYLVANIA, OH 43560-9263
(419) 517-7533
(419) 517-7502
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
35.090990
OH
207X00000X
Orthopaedic Surgery Physician
A97334
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000559947
ANTHEM
—
01
—
05382
PHC
—
05
—
2817723
—
OH
01
—
9873118
AETNA
—
01
—
P00820608
RRMC
OH
Enumeration date
01/22/2007
Last updated
08/06/2015
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