Provider Demographics
NPI:1366505687
Name:HEYSER, BILL G (DC)
Entity Type:Individual
Prefix:
First Name:BILL
Middle Name:G
Last Name:HEYSER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:BILL
Other - Middle Name:G
Other - Last Name:HEYSER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC, MD
Mailing Address - Street 1:1962-A VILLAGE GREEN WAY
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308
Mailing Address - Country:US
Mailing Address - Phone:850-668-0444
Mailing Address - Fax:850-668-7195
Practice Address - Street 1:1962-A VILLAGE GREEN WAY
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308
Practice Address - Country:US
Practice Address - Phone:850-668-0444
Practice Address - Fax:850-668-7195
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005488111N00000X, 111NN0400X, 111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN0400XChiropractic ProvidersChiropractorNeurology
No111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT54817Medicare UPIN
FL22051Medicare PIN