Individual
DR. JEFFREY A. HEISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 N STATE ST STE 100, GREENFIELD, IN 46140-1270
(317) 462-3255
Mailing address
PO BOX 129, GREENFIELD, IN 46140-0129
(317) 468-6270
(317) 468-6268
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01062448A
IN
2086S0102X
Surgical Critical Care Physician
4301080253
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000493483
ANTHEM PIN#
IN
01
—
1114016987
NPI NUMBER FOR HANCOCK REGIONAL PHYSICIAN GROUP
IN
05
—
200841490
—
IN
05
—
200941580A
—
IN
01
—
7612847
AETNA PIN#
IN
Enumeration date
08/12/2006
Last updated
10/08/2010
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