Individual
WILLIAM A HEISEL III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13100 E 136TH ST, STE 1200, FISHERS, IN 46037-9417
(317) 678-3100
(317) 678-3108
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01034463A
IN
207R00000X
Internal Medicine Physician
01034463A
IN
208000000X
Pediatrics Physician
01034463A
IN
208D00000X
General Practice Physician
Primary
01034463A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000375531
ANTHEM
IN
05
—
100357410
—
IN
01
—
P00305970
MEDICARE RAILROAD
IN
Enumeration date
05/18/2006
Last updated
05/23/2025
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