Provider Demographics
NPI:1326405846
Name:HEATH, DAVID SCOTT (PA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:SCOTT
Last Name:HEATH
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:48 TUNNEL RD STE 101
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-3875
Mailing Address - Country:US
Mailing Address - Phone:570-622-2245
Mailing Address - Fax:570-622-2116
Practice Address - Street 1:48 TUNNEL RD STE 101
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-3875
Practice Address - Country:US
Practice Address - Phone:570-622-2245
Practice Address - Fax:570-622-2116
Is Sole Proprietor?:No
Enumeration Date:2016-01-28
Last Update Date:2022-09-29
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Provider Licenses
StateLicense IDTaxonomies
PAOA003738363AM0700X
PAMA058072363AM0700X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical