Provider Demographics
NPI:1851421754
Name:HEATON, LINDSEY G (DC, DACBN, CCN)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:G
Last Name:HEATON
Suffix:
Gender:M
Credentials:DC, DACBN, CCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9025 CHEVROLET DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-4017
Mailing Address - Country:US
Mailing Address - Phone:410-750-2540
Mailing Address - Fax:410-750-2541
Practice Address - Street 1:9025 CHEVROLET DR
Practice Address - Street 2:SUITE D
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-4017
Practice Address - Country:US
Practice Address - Phone:410-750-2540
Practice Address - Fax:410-750-2541
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1468PT111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDM312OtherMARYLAND CAREFIRST GROUP
MD52122902OtherMD CAREFIRST LOCAL #
MDY921-0002OtherCAREFIRST
MDM312OtherMARYLAND CAREFIRST GROUP