Individual
JAMES HEAP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
606 N MAIN ST, EAGAR, AZ 85925-9813
(928) 333-5333
(928) 333-5100
Mailing address
1600 PROVIDENCE DR, ATTN: TRACI MITCHELL - ADMN, WACO, TX 76707-2261
(254) 313-4200
(254) 313-4326
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
54657
AZ
207Q00000X
Family Medicine Physician
BP10054653
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
377055
—
AZ
Enumeration date
06/11/2015
Last updated
09/04/2018
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