Provider Demographics
NPI:1215947197
Name:HEATH, JULIA A (DPH)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:A
Last Name:HEATH
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2609 MONTROSE DR
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-7437
Mailing Address - Country:US
Mailing Address - Phone:918-335-1079
Mailing Address - Fax:
Practice Address - Street 1:3400 E FRANK PHILLIPS BLVD
Practice Address - Street 2:STE #203
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-2495
Practice Address - Country:US
Practice Address - Phone:918-331-2525
Practice Address - Fax:918-331-2589
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13215183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist