Provider Demographics
NPI:1508969312
Name:HECKER, MELINDA MICHELLE (MD)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:MICHELLE
Last Name:HECKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:MICHELLE
Other - Last Name:ZION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:2325 SMILEY LANE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65202
Practice Address - Country:US
Practice Address - Phone:573-884-8980
Practice Address - Fax:573-884-0040
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005041211207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO204920300Medicaid
MO855400OtherHEALTHLINK
MO310395236Medicare PIN
MO310391950Medicare PIN