Provider Demographics
NPI:1710137815
Name:FALLIN, HEATH A (MD)
Entity type:Individual
Prefix:
First Name:HEATH
Middle Name:A
Last Name:FALLIN
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 1:311 W 24TH ST STE 302
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-2666
Mailing Address - Country:US
Mailing Address - Phone:814-452-7246
Mailing Address - Fax:814-452-7244
Practice Address - Street 1:311 W 24TH ST STE 302
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-2666
Practice Address - Country:US
Practice Address - Phone:814-452-7246
Practice Address - Fax:814-452-7244
Is Sole Proprietor?:No
Enumeration Date:2008-09-25
Last Update Date:2025-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2018-01792207LP2900X
PAMD438529207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine