Provider Demographics
NPI:1023115599
Name:HEDDEN, DAVID KIRKE (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:KIRKE
Last Name:HEDDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 BARSTOW RD.
Mailing Address - Street 2:
Mailing Address - City:SHELBURNE
Mailing Address - State:VT
Mailing Address - Zip Code:05482-6986
Mailing Address - Country:US
Mailing Address - Phone:802-985-8739
Mailing Address - Fax:802-985-4960
Practice Address - Street 1:708 BARSTOW RD.
Practice Address - Street 2:
Practice Address - City:SHELBURNE
Practice Address - State:VT
Practice Address - Zip Code:05482-6986
Practice Address - Country:US
Practice Address - Phone:802-985-8739
Practice Address - Fax:802-985-4960
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT69992084P0804X
NY1612612084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry