Individual
MRS. HEIDI JOY BIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2021 S BANEY RD, ASHLAND, OH 44805-4574
(419) 289-1133
Mailing address
2021 S BANEY RD, ASHLAND, OH 44805-4574
(419) 289-1133
(419) 289-1132
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.003875
OH
363A00000X
Physician Assistant
TMA052640
PA
363AM0700X
Medical Physician Assistant
TMA052640
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TMA052640
TEMPORARY PHYSICIAN ASST PRACTICE PERMIT
PA
Enumeration date
06/21/2012
Last updated
11/12/2020
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