Provider Demographics
NPI:1184189821
Name:HEIDEMANN, ERIC ANTHONY (DO)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:ANTHONY
Last Name:HEIDEMANN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2314 HUDSON WAY
Mailing Address - Street 2:APT 105
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901
Mailing Address - Country:US
Mailing Address - Phone:402-641-7720
Mailing Address - Fax:
Practice Address - Street 1:715 N KANSAS AVE STE 106
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-4422
Practice Address - Country:US
Practice Address - Phone:402-462-2139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-06
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS17355207X00000X
NE3016207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery