Provider Demographics
NPI:1417698838
Name:HEINZEN, BAILEY (DO)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:
Last Name:HEINZEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SOIN FAMILY PRACTICE
Mailing Address - Street 2:2145 NORTH FAIRFIELD ROAD, SUITE 100
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431
Mailing Address - Country:US
Mailing Address - Phone:937-558-3900
Mailing Address - Fax:937-558-3999
Practice Address - Street 1:SOIN FAMILY PRACTICE
Practice Address - Street 2:2145 NORTH FAIRFIELD ROAD, SUITE 100
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431
Practice Address - Country:US
Practice Address - Phone:937-558-3900
Practice Address - Fax:937-558-3999
Is Sole Proprietor?:No
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program