Organization
KENNETH A. HEISLER, M.D.P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH AVERY HEISLER (M.D./OWNER)
(508) 548-8317
Entity
Organization
Contact information
Practice address
78 MAIN ST, FALMOUTH, MA 02540-2692
(508) 548-8317
Mailing address
78 MAIN ST, FALMOUTH, MA 02540-2692
(508) 548-8317
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9728635
—
MA
01
—
M13557
BC/BS
MA
Enumeration date
11/15/2007
Last updated
12/23/2010
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