Individual
RICHARD R HECKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2253 W MASON ST STE 100, GREEN BAY, WI 54303-4706
(920) 327-7000
(920) 327-7005
Mailing address
PO BOX 28900, GREEN BAY, WI 54324-0900
(920) 490-9046
(920) 327-7005
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
32665
WI
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
32665
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104289893
—
MI
01
—
180034985
RAILROAD
WI
05
—
31753100
—
WI
Enumeration date
06/22/2006
Last updated
03/23/2022
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