Individual
DR. JASON ODELL HEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 S LAKE PARK AVE, SUITE 405, HOBART, IN 46342-6636
(219) 942-8583
(219) 942-8979
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
01056990A
IN
207V00000X
Obstetrics & Gynecology Physician
Primary
C162695
CA
Other
Enumeration date
08/29/2005
Last updated
10/06/2021
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