Provider Demographics
NPI:1033444930
Name:HECKMAN, ALEXANDER (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:
Last Name:HECKMAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 NORTHSIDE FORSYTH DR
Mailing Address - Street 2:STE 3500
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041
Mailing Address - Country:US
Mailing Address - Phone:770-667-4337
Mailing Address - Fax:770-667-4338
Practice Address - Street 1:1505 NORTHSIDE FORSYTH DR
Practice Address - Street 2:STE 3500
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041
Practice Address - Country:US
Practice Address - Phone:770-667-4337
Practice Address - Fax:770-667-4338
Is Sole Proprietor?:No
Enumeration Date:2009-10-09
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA20597363A00000X
GA007805363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003174364FMedicaid
GA003174364EMedicaid
GA003174364GMedicaid
GA003174364GMedicaid