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Individual

LARRY K HEATH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
493 BLACKWELL RD, SUITE 101A, WARRENTON, VA 20186-2639
(540) 316-4325
(540) 316-4331
Mailing address
136 LINDEN DR, SUITE 104, WINCHESTER, VA 22601-6900
(540) 678-3588
(540) 678-9025

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101243352
VA
207R00000X
Internal Medicine Physician
32455
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
31770600
WI
Enumeration date
08/21/2006
Last updated
08/02/2011
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