Provider Demographics
NPI:1871619627
Name:PAUL F. HEYSE, MD, INC
Entity type:Organization
Organization Name:PAUL F. HEYSE, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:F
Authorized Official - Last Name:HEYSE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:937-296-0300
Mailing Address - Street 1:PO BOX 714658
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43271-4658
Mailing Address - Country:US
Mailing Address - Phone:937-296-0300
Mailing Address - Fax:
Practice Address - Street 1:4649 SCHRUBB DR
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-1984
Practice Address - Country:US
Practice Address - Phone:937-296-0300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0431882086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty