Provider Demographics
NPI:1124178959
Name:HEUSER, DAVID F
Entity Type:Individual
Prefix:PROF
First Name:DAVID
Middle Name:F
Last Name:HEUSER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2669 S DIXIE DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409
Mailing Address - Country:US
Mailing Address - Phone:937-643-0893
Mailing Address - Fax:937-643-0892
Practice Address - Street 1:2669 S DIXIE DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409
Practice Address - Country:US
Practice Address - Phone:937-643-0893
Practice Address - Fax:937-643-0892
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2181111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2159284Medicaid
OHT52258Medicare UPIN
OH0804102Medicare PIN