Individual
RICKY DANIEL HEATH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
529 TERRY REILEY WAY, POTTSVILLE, PA 17901-1774
(570) 624-4444
(570) 624-4445
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD466865
PA
207R00000X
Internal Medicine Physician
ME135252
FL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
MD466865
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100987100
—
FL
01
—
HB94H
BCBS
FL
01
—
JM837
MEDICARE
FL
Enumeration date
04/06/2013
Last updated
10/13/2022
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