Provider Demographics
NPI:1700878162
Name:HEEB, CHRISTOPHER A (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:A
Last Name:HEEB
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:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-341-0288
Mailing Address - Fax:859-341-7482
Practice Address - Street 1:2900 CHANCELLOR DR
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-5427
Practice Address - Country:US
Practice Address - Phone:859-341-0288
Practice Address - Fax:859-341-7482
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY29619207R00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200916590Medicaid
000000044597OtherANTHEM
021036000OtherFEDERAL BLACK LUNG
0420748OtherUNITED HEALTHCARE
50006697OtherPASSPORT
OH2466497Medicaid
637135OtherAETNA
KY64296197Medicaid
KYP00935629OtherRAIL ROAD MEDICARE
310674100OtherUS DEPT OF LABOR
KYP00935629OtherRAILROAD MEDICARE
KY110221932Medicare PIN
KYP400040669Medicare PIN
KY3400136Medicare PIN
310674100OtherUS DEPT OF LABOR
KY110071082Medicare PIN
F58634Medicare UPIN
OH2466497Medicaid
KY0399006Medicare PIN