Provider Demographics
NPI:1003830951
Name:HEISEY, JOHN CLAYMON JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CLAYMON
Last Name:HEISEY
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:50 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-3335
Mailing Address - Country:US
Mailing Address - Phone:610-372-8044
Mailing Address - Fax:484-334-7026
Practice Address - Street 1:4885 DEMOSS RD
Practice Address - Street 2:SUITE 200
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-9023
Practice Address - Country:US
Practice Address - Phone:610-779-0300
Practice Address - Fax:610-779-8083
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2012-05-18
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Provider Licenses
StateLicense IDTaxonomies
PAMD014667E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000645838Medicaid
PA000645838Medicaid