Individual
TERESA CAROL HEATLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5151 E BROADWAY RD STE 107, MESA, AZ 85206-1346
(480) 290-7000
(480) 325-3461
Mailing address
5151 E BROADWAY RD STE 107, MESA, AZ 85206-1346
(480) 290-7000
(602) 254-6840
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
23465
AZ
207R00000X
Internal Medicine Physician
3600-320
WI
207RP1001X
Pulmonary Disease Physician
Primary
23465
AZ
207RP1001X
Pulmonary Disease Physician
3600-320
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100258873
—
WI
05
—
318677
—
AZ
Enumeration date
07/27/2006
Last updated
10/07/2025
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