Individual
JESSICA L HEINTZELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
60 NORTH AVE, TALLMADGE, OH 44278-2011
(330) 630-9726
(330) 630-2194
Mailing address
60 NORTH AVE, TALLMADGE, OH 44278-2011
(330) 630-9726
(330) 630-2194
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34.011657
OH
207Q00000X
Family Medicine Physician
Primary
39084
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39084A
—
SC
01
—
SC88755019
MEDICARE PIN
SC
Enumeration date
03/27/2013
Last updated
02/10/2026
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