Provider Demographics
NPI:1326486580
Name:HEIMBURGER, IRVIN LEROY (MD)
Entity Type:Individual
Prefix:DR
First Name:IRVIN
Middle Name:LEROY
Last Name:HEIMBURGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 NEWBURGH RD
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-4530
Mailing Address - Country:US
Mailing Address - Phone:812-477-1823
Mailing Address - Fax:
Practice Address - Street 1:7700 NEWBURGH RD
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-4530
Practice Address - Country:US
Practice Address - Phone:812-477-1823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01018561A174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist