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Individual

DR. JAMISON J HEFFRON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
507 S L ROGERS WELLS BLVD, SUITE B, GLASGOW, KY 42141-1047
(270) 629-2015
(270) 629-2016
Mailing address
507 S L ROGERS WELLS BLVD, SUITE B, GLASGOW, KY 42141-1047
(270) 629-2015
(270) 629-2016

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1319DT
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000199532
BCBS
01
410049287
RAILROAD MEDICARE
AL
05
77013191
KY
Enumeration date
07/08/2005
Last updated
05/04/2008
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