Individual
THOMAS F HESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
25 JACOBS GULCH RD, KELLOGG, ID 83837-2023
(208) 783-1267
Mailing address
25 JACOBS GULCH RD, KELLOGG, ID 83837-2023
(208) 783-1267
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M6643
ID
207U00000X
Nuclear Medicine Physician
M6643
ID
207UN0901X
Nuclear Cardiology Physician
MD00032355
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0197912
L&I (REGULAR)
WA
01
—
3976HE
REGENCE BLUESHIELD
WA
01
—
423898078
GROUP HEALTH COOPERATIVE
WA
05
—
804135600
—
ID
05
—
8192759
—
WA
01
—
8906064
L&I (CRIME VICTIM)
WA
01
—
P00305935
RAILROAD MEDICARE
WA
Enumeration date
05/23/2006
Last updated
02/13/2014
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