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Organization

SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC

Active
Other names
R David Heekin, MD, PA
Organization subpart
No

Provider details

NPI number
Authorized official
BRETT PUCKETT MD (AUTHORIZED OFFICIAL)
(904) 634-0640
Entity
Organization

Contact information

Practice address
2627 RIVERSIDE AVE FL 3, JACKSONVILLE, FL 32204-4717
(904) 634-0640
(904) 634-0203
Mailing address
6800 SOUTHPOINT PKWY STE 300, JACKSONVILLE, FL 32216-8203
(904) 634-0640
(904) 634-0203

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
207QS0010X
Sports Medicine (Family Medicine) Physician
207X00000X
Orthopaedic Surgery Physician
Primary
207XS0106X
Orthopaedic Hand Surgery Physician
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
207XX0801X
Orthopaedic Trauma Physician
208VP0000X
Pain Medicine Physician
208VP0014X
Interventional Pain Medicine Physician
213E00000X
Podiatrist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
107540800
FL
05
107540805
FL
05
107540807
FL
05
107540808
FL
05
107540810
FL
05
107540811
FL
05
107540813
FL
05
107540814
FL
05
107540816
FL
05
107540817
FL
05
107540818
FL
05
107540819
FL
Enumeration date
05/31/2006
Last updated
12/09/2025
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