Provider Demographics
NPI:1780670695
Name:HECK, GARY HERSCHEL (DO)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:HERSCHEL
Last Name:HECK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:744 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28504-8800
Mailing Address - Country:US
Mailing Address - Phone:252-523-0026
Mailing Address - Fax:252-523-1855
Practice Address - Street 1:744 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28504-8800
Practice Address - Country:US
Practice Address - Phone:252-523-0026
Practice Address - Fax:252-523-1855
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC40032207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCH300BOtherMEDICARE
NCE75932Medicare UPIN
NCE75932Medicare UPIN
NC1467405431OtherGROUP NPI NUMBER
NC2157953ROtherMEDICARE PART B
NC8901960OtherEASTERN CAROLINA PHYSICIANS GROUP MEDICAID NUMBER FOR KINSTON
560989277OtherGROUP TAX ID
2157953NMedicare ID - Type Unspecified