Individual
MR. JACOB HEIDISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
5040 FOREST DR STE 300, NEW ALBANY, OH 43054-8166
(614) 890-6555
Mailing address
6480 HARRISON AVE STE 201, CINCINNATI, OH 45247-7961
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
50.009220RX
OH
Other
Enumeration date
01/07/2025
Last updated
02/04/2025
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