Individual
DR. RANDY ROBERT HEISSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1508 TOMBRAS AVE, EAST RIDGE, TN 37412-2720
(423) 867-4969
(423) 867-4971
Mailing address
1508 TOMBRAS AVE, EAST RIDGE, TN 37412-2720
(423) 867-4969
(423) 867-4971
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26726
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1515872
—
TN
01
—
4165919
BCBS- TN
TN
01
—
F40535
HEALTHSPRINGS
TN
01
—
TN0104
JOHN DEERE HEALTH
TN
Enumeration date
05/26/2006
Last updated
04/24/2018
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