Individual
DR. JOHN SLOAN HEAVRIN I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1335 PHAY AVE STE B, CANON CITY, CO 81212-2349
(719) 285-2735
(719) 285-2915
Mailing address
1335 PHAY AVE STE B, CANON CITY, CO 81212-2349
(719) 285-2735
(719) 285-2915
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
24475
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01244755
—
CO
01
—
160057345
RR MEDICARE PIN
CO
Enumeration date
05/05/2006
Last updated
03/17/2018
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