Provider Demographics
NPI:1689735011
Name:HEATHCOTT, JULIEANN K (MD)
Entity Type:Individual
Prefix:
First Name:JULIEANN
Middle Name:K
Last Name:HEATHCOTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9823 N 95TH ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4585
Mailing Address - Country:US
Mailing Address - Phone:480-451-8454
Mailing Address - Fax:480-451-3466
Practice Address - Street 1:9823 N 95TH ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4585
Practice Address - Country:US
Practice Address - Phone:480-451-8454
Practice Address - Fax:480-451-3466
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ29469207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZH44694Medicare UPIN