Provider Demographics
NPI:1417274242
Name:ANDREWS, HEATHER FALLON (MD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:FALLON
Last Name:ANDREWS
Suffix:
Gender:F
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:PO BOX 748860
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-1399
Mailing Address - Country:US
Mailing Address - Phone:602-240-2401
Mailing Address - Fax:602-792-0244
Practice Address - Street 1:650 W MARYLAND AVE STE 1
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-1399
Practice Address - Country:US
Practice Address - Phone:602-240-2401
Practice Address - Fax:602-792-0244
Is Sole Proprietor?:No
Enumeration Date:2010-05-04
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ43177207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ518191Medicaid