Provider Demographics
NPI:1255397683
Name:HEOB, WILLIAM G (MSCCC-A)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:G
Last Name:HEOB
Suffix:
Gender:M
Credentials:MSCCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7331 E OSBORN DR
Mailing Address - Street 2:#245
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6435
Mailing Address - Country:US
Mailing Address - Phone:480-949-1541
Mailing Address - Fax:480-949-0342
Practice Address - Street 1:7331 E OSBORN DR
Practice Address - Street 2:#245
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6435
Practice Address - Country:US
Practice Address - Phone:480-949-1541
Practice Address - Fax:480-949-0342
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ815231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZR03020Medicare UPIN