Provider Demographics
NPI:1568602944
Name:KRISTEN HECK, O.D.
Entity Type:Organization
Organization Name:KRISTEN HECK, O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:HECK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:256-245-4104
Mailing Address - Street 1:41301 US HIGHWAY 280
Mailing Address - Street 2:
Mailing Address - City:SYLACAUGA
Mailing Address - State:AL
Mailing Address - Zip Code:35150-8046
Mailing Address - Country:US
Mailing Address - Phone:256-245-4104
Mailing Address - Fax:256-245-8668
Practice Address - Street 1:41301 US HIGHWAY 280
Practice Address - Street 2:
Practice Address - City:SYLACAUGA
Practice Address - State:AL
Practice Address - Zip Code:35150-8046
Practice Address - Country:US
Practice Address - Phone:256-245-4104
Practice Address - Fax:256-245-8668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-25
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-A82-TA-661152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty