Provider Demographics
NPI:1902865793
Name:HEERE, BARBARA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:ANN
Last Name:HEERE
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 1:1201 GRAMPIAN BLVD
Mailing Address - Street 2:SUITE 1K
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-1900
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:904 CAMPBELL ST
Practice Address - Street 2:SUITE 102
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-3154
Practice Address - Country:US
Practice Address - Phone:570-321-2284
Practice Address - Fax:570-321-2289
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025531E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001743OtherFIRST PRIORITY HEALTH
PA119470OtherUNITEDHEALTHCARE
PA437815OtherHIGHMARK BLUE SHIELD
PA511134OtherAETNA
PA0009283320001Medicaid
PAB41824OtherHEALTHAMERICA
PA511134OtherAETNA
PA110183790Medicare PIN