Individual
DR. JASON J. HEISLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5050 N CLINTON ST, FORT WAYNE, IN 46825-5886
(260) 484-8551
(260) 482-5060
Mailing address
5052 N CLINTON ST, FORT WAYNE, IN 46825-5822
(260) 484-8551
(260) 482-5060
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
02003175A
IN
207X00000X
Orthopaedic Surgery Physician
5101015382
MI
207XX0801X
Orthopaedic Trauma Physician
Primary
02003175A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02003175A
INDIANA LICENSE
IN
05
—
200882680
—
IN
01
—
P00651304
RR MEDICARE
IN
Enumeration date
04/06/2007
Last updated
10/22/2018
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