Provider Demographics
NPI:1427224187
Name:PEGGY A HEIS MD LLC
Entity Type:Organization
Organization Name:PEGGY A HEIS MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RECEPTIONIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SUCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-481-5300
Mailing Address - Street 1:5680 BRIDGETOWN RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45248-4383
Mailing Address - Country:US
Mailing Address - Phone:513-481-5300
Mailing Address - Fax:513-389-7960
Practice Address - Street 1:5680 BRIDGETOWN RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45248-4383
Practice Address - Country:US
Practice Address - Phone:513-481-5300
Practice Address - Fax:513-389-7960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-02
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-064036207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0794193Medicare PIN