Individual
ROBERT RANDAL HEAVNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1212 GARFIELD AVE STE 202, PARKERSBURG, WV 26101-3247
(304) 865-3611
(302) 577-2169
Mailing address
1212 GARFIELD AVE STE 202, PARKERSBURG, WV 26101-3247
(304) 865-3611
(304) 577-2169
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15128
WV
207Q00000X
Family Medicine Physician
35.058410
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0052632000
—
WV
05
—
0815158
—
OH
Enumeration date
05/24/2005
Last updated
03/30/2026
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