Provider Demographics
NPI:1508495326
Name:DEREK HELDZINGER PROFESSIONAL, LLC
Entity Type:Organization
Organization Name:DEREK HELDZINGER PROFESSIONAL, LLC
Other - Org Name:FAMILY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF MEDICINE/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:HELDZINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-827-9222
Mailing Address - Street 1:102 RBC DR
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736-2787
Mailing Address - Country:US
Mailing Address - Phone:814-243-0414
Mailing Address - Fax:814-479-5906
Practice Address - Street 1:102 RBC DR
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-2787
Practice Address - Country:US
Practice Address - Phone:814-243-0414
Practice Address - Fax:814-479-5906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-03
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty