Provider Demographics
NPI:1699770271
Name:HEINEMANN, FREDERICK MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:MICHAEL
Last Name:HEINEMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1661 AIRPORT RD STE D
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-8184
Mailing Address - Country:US
Mailing Address - Phone:501-625-7500
Mailing Address - Fax:501-625-7777
Practice Address - Street 1:2266 ALBERT PIKE RD
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-4003
Practice Address - Country:US
Practice Address - Phone:501-767-1144
Practice Address - Fax:501-767-4455
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR3044207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR102438001Medicaid
ARC68478Medicare UPIN
AR52298Medicare ID - Type Unspecified
AR52298OtherBCBS OF AR
AR102438001Medicaid