Provider Demographics
NPI:1700965175
Name:HEIT, STACEY CATHLEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:STACEY
Middle Name:CATHLEEN
Last Name:HEIT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:NORTHSIDE HOSPITAL- MANAGED CARE DEPT
Mailing Address - Street 2:1000 JOHNSON FERRY RD
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1606
Mailing Address - Country:US
Mailing Address - Phone:404-300-2476
Mailing Address - Fax:404-250-8010
Practice Address - Street 1:11755 POINTE PL
Practice Address - Street 2:SUITE A1
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4636
Practice Address - Country:US
Practice Address - Phone:770-667-1264
Practice Address - Fax:770-667-2238
Is Sole Proprietor?:No
Enumeration Date:2006-11-04
Last Update Date:2019-01-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA413072084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA26BDJSDMedicare PIN
G86824Medicare UPIN
GA26BDHXDMedicare PIN