Provider Demographics
NPI:1457377715
Name:HEIN, JEFFERY P (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:P
Last Name:HEIN
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 1:210 OHIO RIVER BLVD
Mailing Address - Street 2:
Mailing Address - City:BADEN
Mailing Address - State:PA
Mailing Address - Zip Code:15005-1914
Mailing Address - Country:US
Mailing Address - Phone:724-869-6002
Mailing Address - Fax:724-869-6005
Practice Address - Street 1:210 OHIO RIVER BLVD
Practice Address - Street 2:
Practice Address - City:BADEN
Practice Address - State:PA
Practice Address - Zip Code:15005-1914
Practice Address - Country:US
Practice Address - Phone:724-869-6002
Practice Address - Fax:724-869-6005
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD053811L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001518642001Medicaid
G04927Medicare UPIN
PA001518642001Medicaid