Provider Demographics
NPI:1285763680
Name:HEINZ, JAMES DAVID (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DAVID
Last Name:HEINZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2939 SANDRA LN
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-1815
Mailing Address - Country:US
Mailing Address - Phone:404-377-3377
Mailing Address - Fax:770-939-9353
Practice Address - Street 1:2545 LAWRENCEVILLE HWY STE 100
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-3241
Practice Address - Country:US
Practice Address - Phone:404-377-3377
Practice Address - Fax:770-939-9353
Is Sole Proprietor?:No
Enumeration Date:2007-03-04
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5323111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA56352Medicare UPIN
GA35ZCFZPMedicare ID - Type Unspecified