Individual
HEATHER R RICKETTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4199 GATEWAY BLVD STE 2400, NEWBURGH, IN 47630-7972
(812) 858-4600
(812) 858-4635
Mailing address
4199 GATEWAY BLVD STE 2400, NEWBURGH, IN 47630-7972
(812) 858-4600
(812) 858-4601
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01077418A
IN
207V00000X
Obstetrics & Gynecology Physician
40327
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000393400
BCBS PROVIDER NUMBER
—
01
—
01077418A
INDIANA LICENSE
IN
01
—
1920014
IN MEDICARE
IN
05
—
201380400
—
IN
01
—
40327
MEDICAL LICENSE
KY
05
—
64123904
—
KY
01
—
LICENSE
TP720
KY
Enumeration date
08/03/2006
Last updated
03/30/2026
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