Provider Demographics
NPI:1013952928
Name:HEFFINGTON, MARK W (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:W
Last Name:HEFFINGTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1828
Mailing Address - Street 2:
Mailing Address - City:CASHIERS
Mailing Address - State:NC
Mailing Address - Zip Code:28717-1828
Mailing Address - Country:US
Mailing Address - Phone:828-743-2491
Mailing Address - Fax:828-743-3060
Practice Address - Street 1:57 WHITE OWL LANE
Practice Address - Street 2:
Practice Address - City:CASHIERS
Practice Address - State:NC
Practice Address - Zip Code:28717-1828
Practice Address - Country:US
Practice Address - Phone:828-743-2491
Practice Address - Fax:828-743-3060
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC26108207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8941098Medicaid
NC202666BMedicare ID - Type Unspecified
NC8941098Medicaid