Organization
GWEN HEATON, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWEN HEATON MD (OWNER)
(812) 265-4151
Entity
Organization
Contact information
Practice address
606 E MAIN ST, MADISON, IN 47250-4708
(812) 265-4151
(812) 265-5028
Mailing address
606 E MAIN ST, MADISON, IN 47250-4708
(812) 265-4151
(812) 265-5028
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
33002012A
IN
104100000X
Social Worker
34004330A
IN
1041C0700X
Clinical Social Worker
Primary
34000171A
IN
1041C0700X
Clinical Social Worker
34001704A
IN
106H00000X
Marriage & Family Therapist
35000907A
IN
106H00000X
Marriage & Family Therapist
35000998A
IN
2084P0800X
Psychiatry Physician
01035782
IN
Other
Enumeration date
03/06/2007
Last updated
09/11/2025
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