Provider Demographics
NPI:1578657375
Name:HEFFERNAN ASSALEY & LEE M D INC.
Entity Type:Organization
Organization Name:HEFFERNAN ASSALEY & LEE M D INC.
Other - Org Name:HUNTINGTON WOMEN'S HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:CRENTIALING MANAGER
Authorized Official - Phone:304-522-3420
Mailing Address - Street 1:1660 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3833
Mailing Address - Country:US
Mailing Address - Phone:304-522-3420
Mailing Address - Fax:304-529-4645
Practice Address - Street 1:1660 12TH AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3833
Practice Address - Country:US
Practice Address - Phone:304-522-3420
Practice Address - Fax:304-529-4645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty