Individual
BRET D. HEILESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2600 MILLER ST, BETHANY, MO 64424-2701
(660) 425-2211
Mailing address
2600 MILLER ST, BETHANY, MO 64424-2701
(660) 425-0201
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2023042086
MO
207P00000X
Emergency Medicine Physician
32622
IA
207Q00000X
Family Medicine Physician
Primary
32622
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200134943
—
MO
05
—
2178046
—
IA
Enumeration date
12/13/2005
Last updated
07/16/2024
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