Provider Demographics
NPI:1497802631
Name:DOUGLAS B. HEIM, O.D.
Entity Type:Organization
Organization Name:DOUGLAS B. HEIM, O.D.
Other - Org Name:DOUGLAS B. HEIM, O.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:B
Authorized Official - Last Name:HEIM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:828-692-2593
Mailing Address - Street 1:3450 ASHEVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-0701
Mailing Address - Country:US
Mailing Address - Phone:828-692-2593
Mailing Address - Fax:828-693-5558
Practice Address - Street 1:3450 ASHEVILLE HWY
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-0701
Practice Address - Country:US
Practice Address - Phone:828-692-2593
Practice Address - Fax:828-693-5558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1070152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC014P7OtherBCBS OF NC
NCDA2583OtherRAILROAD MEDICARE
NC89014P7Medicaid
NCDA2583OtherRAILROAD MEDICARE
NC0689210001Medicare NSC