Provider Demographics
NPI:1811196264
Name:MCNAUGHTON, HEATHER N (PT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:N
Last Name:MCNAUGHTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:SOLLIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1908 FLINT RD SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-6031
Mailing Address - Country:US
Mailing Address - Phone:256-340-9708
Mailing Address - Fax:256-340-9624
Practice Address - Street 1:5420 HIGHWAY 90 W
Practice Address - Street 2:TILLMAN'S CORNER
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36619
Practice Address - Country:US
Practice Address - Phone:251-660-1505
Practice Address - Fax:251-660-9007
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH5035225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-41951OtherBCBS
AL890022690Medicaid
AL1003819608OtherNPI GROUP
ALDB9027OtherRAILROAD MEDICARE
AL7854957OtherAETNA
AL7854957OtherAETNA
AL515-41951OtherBCBS