Provider Demographics
NPI:1023053964
Name:HIEB, LOUIS ALAN (DO)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:ALAN
Last Name:HIEB
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 COMMUNICATION WAY
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-8137
Mailing Address - Country:US
Mailing Address - Phone:508-862-7875
Mailing Address - Fax:508-862-7997
Practice Address - Street 1:525 LONG POND DR
Practice Address - Street 2:
Practice Address - City:HARWICH
Practice Address - State:MA
Practice Address - Zip Code:02645-1227
Practice Address - Country:US
Practice Address - Phone:508-432-4100
Practice Address - Fax:508-432-8951
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013276207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1013957320001Medicaid
PA097748RNAMedicare ID - Type Unspecified
PAF31959Medicare UPIN