Provider Demographics
NPI:1558542860
Name:BILL G HEYSER, D.C., M.D.
Entity Type:Organization
Organization Name:BILL G HEYSER, D.C., M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:G
Authorized Official - Last Name:HEYSER
Authorized Official - Suffix:
Authorized Official - Credentials:DC, MD
Authorized Official - Phone:850-668-0444
Mailing Address - Street 1:1962-A VILLAGE GREEN WAY
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308
Mailing Address - Country:US
Mailing Address - Phone:850-668-0444
Mailing Address - Fax:850-668-7195
Practice Address - Street 1:1913 BUFORD BLVD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4466
Practice Address - Country:US
Practice Address - Phone:850-668-0444
Practice Address - Fax:850-668-7195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005488111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT54817Medicare UPIN
FL22051Medicare PIN