Individual
GEORGE J HEINZ III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 N. OAKLAND AVE., BOLIVAR, MO 65613
(417) 328-6631
Mailing address
1500 N OAKLAND AVE, BOLIVAR, MO 65613-3011
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MDR8060
MO
Other
Enumeration date
11/14/2006
Last updated
07/09/2007
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