Provider Demographics
NPI:1568445773
Name:REESE, HEATHER F (OD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:F
Last Name:REESE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:HEATHER
Other - Middle Name:F
Other - Last Name:EDDINGTON-REESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:8333 N DAVIS HWY
Mailing Address - Street 2:MEDICAL CENTER CLINIC OPTOMETRY DEPT
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514
Mailing Address - Country:US
Mailing Address - Phone:850-474-8651
Mailing Address - Fax:850-969-2989
Practice Address - Street 1:8333 N DAVIS HWY
Practice Address - Street 2:MEDICAL CENTER CLINIC OPTOMETRY DEPT
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514
Practice Address - Country:US
Practice Address - Phone:850-474-8100
Practice Address - Fax:850-474-8083
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC03447152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U81825Medicare UPIN