Provider Demographics
NPI:1790883551
Name:HEALY, DAVID PATRICK (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PATRICK
Last Name:HEALY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 677
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-0677
Mailing Address - Country:US
Mailing Address - Phone:740-657-1122
Mailing Address - Fax:740-657-1148
Practice Address - Street 1:500 S CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8971
Practice Address - Country:US
Practice Address - Phone:740-657-1122
Practice Address - Fax:740-657-1148
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-997249H207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2557335Medicaid
OHH91487Medicare UPIN
OH4151501Medicare ID - Type Unspecified