Individual
DR. JAMES K HEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1640 HIGHWAY 88, SUITE 203, BRICK, NJ 08724-3036
(732) 458-7777
(732) 263-9470
Mailing address
523 PRINCETON AVE, BRICK, NJ 08724-4827
(732) 295-2825
(732) 263-9470
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA03492800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110172482
RAILROAD MEDICARE
NJ
01
—
1K8145
HEALTHNET
NJ
01
—
223360408-010
QUALCARE
NJ
05
—
4745809
—
NJ
01
—
P1043622
OXFORD
NJ
Enumeration date
02/08/2006
Last updated
04/24/2013
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