Provider Demographics
NPI:1225175953
Name:BRIGHT, HEATHER KATHLEEN (DO)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:KATHLEEN
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:KATHLEEN
Other - Last Name:FLORENCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:29 CABANISS CRES APT 3
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32508-1086
Mailing Address - Country:US
Mailing Address - Phone:251-288-9311
Mailing Address - Fax:
Practice Address - Street 1:4713 HIGHWAY 90
Practice Address - Street 2:AMERICAN FAMILY CARE
Practice Address - City:PACE
Practice Address - State:FL
Practice Address - Zip Code:32571-1403
Practice Address - Country:US
Practice Address - Phone:185-030-4069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 12949208D00000X, 208600000X
TNDO0000002686208D00000X, 208600000X
OH008960208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208600000XAllopathic & Osteopathic PhysiciansSurgery