Provider Demographics
NPI:1952628778
Name:ADKINS, HEATHER HARTMAN (MD)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:HARTMAN
Last Name:ADKINS
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 1:3170 KETTERING BLVD BLDG B
Mailing Address - Street 2:
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1924
Mailing Address - Country:US
Mailing Address - Phone:937-991-3188
Mailing Address - Fax:937-223-9811
Practice Address - Street 1:4040 ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-6619
Practice Address - Country:US
Practice Address - Phone:513-424-0941
Practice Address - Fax:513-424-9758
Is Sole Proprietor?:No
Enumeration Date:2010-05-04
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35126169208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0128565Medicaid
OHH323800Medicare UPIN