Provider Demographics
NPI:1720666258
Name:HEANER, DAVID PRINCE JR (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:PRINCE
Last Name:HEANER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1110 W PEACHTREE ST NW STE 1100
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3609
Mailing Address - Country:US
Mailing Address - Phone:404-892-2131
Mailing Address - Fax:404-215-9222
Practice Address - Street 1:6135 BARFIELD RD STE 200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-4308
Practice Address - Country:US
Practice Address - Phone:404-256-8500
Practice Address - Fax:404-256-8506
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
GA99272207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program