Provider Demographics
NPI:1134748981
Name:HEATON, ABIGAIL KATHERINE (DO)
Entity type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:KATHERINE
Last Name:HEATON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:332 S MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:REPUBLIC
Mailing Address - State:MO
Mailing Address - Zip Code:65738-1861
Mailing Address - Country:US
Mailing Address - Phone:417-732-5050
Mailing Address - Fax:
Practice Address - Street 1:6675 HOLMES RD STE 450
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-1173
Practice Address - Country:US
Practice Address - Phone:816-995-3070
Practice Address - Fax:816-276-7090
Is Sole Proprietor?:No
Enumeration Date:2020-04-12
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023015321207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine