Provider Demographics
NPI:1497450274
Name:PAGE, HEIDI LEANNE (MD)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:LEANNE
Last Name:PAGE
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 1:4461 STATE ROUTE 159 STE A
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-6000
Mailing Address - Country:US
Mailing Address - Phone:316-258-1824
Mailing Address - Fax:
Practice Address - Street 1:4461 STATE ROUTE 159 STE A
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-6000
Practice Address - Country:US
Practice Address - Phone:740-779-4900
Practice Address - Fax:740-779-4909
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.254660207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine