Provider Demographics
NPI:1699885608
Name:HEYART, GREGORY RAY (DC)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:RAY
Last Name:HEYART
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 TOWER WAY
Mailing Address - Street 2:SUITE 130
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309
Mailing Address - Country:US
Mailing Address - Phone:661-327-2622
Mailing Address - Fax:661-327-0614
Practice Address - Street 1:1001 TOWER WAY
Practice Address - Street 2:SUITE 130
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309
Practice Address - Country:US
Practice Address - Phone:661-327-2622
Practice Address - Fax:661-327-2622
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC16121111NN0400X, 111NN1001X, 111NR0200X
CADC161210111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN0400XChiropractic ProvidersChiropractorNeurology
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NR0200XChiropractic ProvidersChiropractorRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0161210Medicare UPIN