Provider Demographics
NPI:1326117151
Name:HEARTLAND ORTHOPAEDIC ASSOCIATES
Entity Type:Organization
Organization Name:HEARTLAND ORTHOPAEDIC ASSOCIATES
Other - Org Name:ELIZABETHTOWN ORTHOPAEDIC ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARCIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-737-4343
Mailing Address - Street 1:1113 WOODLAND DRIVE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701
Mailing Address - Country:US
Mailing Address - Phone:270-737-4343
Mailing Address - Fax:270-769-1072
Practice Address - Street 1:1113 WOODLAND DRIVE
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701
Practice Address - Country:US
Practice Address - Phone:270-737-4343
Practice Address - Fax:270-769-1072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty