Provider Demographics
NPI:1457550881
Name:FAULKNER, HEATHER ROSEN (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:ROSEN
Last Name:FAULKNER
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:ROSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:550 PEACHTREE ST NE FL 9
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2212
Mailing Address - Country:US
Mailing Address - Phone:404-686-8143
Mailing Address - Fax:
Practice Address - Street 1:550 PEACHTREE ST NE FL 9
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2212
Practice Address - Country:US
Practice Address - Phone:404-686-8143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA89681208200000X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery