Individual
DR. ADAM HEINER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3541 W BAVARIA ST, EAGLE, ID 83616-6318
(208) 939-5005
(208) 939-2496
Mailing address
3541 W BAVARIA ST, EAGLE, ID 83616-6318
(208) 939-5005
(208) 939-2496
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP 1041
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806965200
—
ID
Enumeration date
09/30/2005
Last updated
04/01/2021
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