Individual
TIMOTHY RYAN HEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
30 CHOCTAW ST, ASHEVILLE, NC 28801-4513
(828) 255-7733
Mailing address
PO BOX 603443, CHARLOTTE, NC 28260-3443
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2011-00036
NC
207RP1001X
Pulmonary Disease Physician
Primary
2011-00036
NC
Other
Enumeration date
05/09/2008
Last updated
12/14/2016
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