Provider Demographics
NPI:1346305661
Name:WALDROP, HEATHER H (DC)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:H
Last Name:WALDROP
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:HEATHER
Other - Middle Name:M
Other - Last Name:HARPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:202 S MADISON ST
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-5479
Mailing Address - Country:US
Mailing Address - Phone:229-226-1035
Mailing Address - Fax:229-226-3378
Practice Address - Street 1:202 S MADISON ST
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-5479
Practice Address - Country:US
Practice Address - Phone:229-226-1035
Practice Address - Fax:229-226-3378
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA7678111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA138360321AMedicaid
GAV01109Medicare UPIN
GA138360321AMedicaid