Individual
JUANITA TITRUD HEERSINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3113 WESLEY WAY STE 2, DOTHAN, AL 36305-2004
(334) 479-0007
(334) 479-0057
Mailing address
3113 WESLEY WAY STE 2, DOTHAN, AL 36305-2004
(334) 479-0007
(334) 479-0023
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
32100
AL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
32100
AL
Other
Enumeration date
04/08/2011
Last updated
01/16/2024
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