Provider Demographics
NPI:1689062614
Name:HECKER INSTITUTE PLLC
Entity Type:Organization
Organization Name:HECKER INSTITUTE PLLC
Other - Org Name:HECKER SPORTS AND REGENERATIVE MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HECKER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:970-631-8877
Mailing Address - Street 1:2315 E HARMONY RD STE 130
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-8620
Mailing Address - Country:US
Mailing Address - Phone:970-631-8877
Mailing Address - Fax:
Practice Address - Street 1:2315 E HARMONY RD STE 130
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-8620
Practice Address - Country:US
Practice Address - Phone:970-980-8460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-29
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000498213ES0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO463127Medicare PIN