Provider Demographics
NPI:1912114943
Name:PAXTON, HEATHER LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:LEE
Last Name:PAXTON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:28 CRESCENT STREET
Mailing Address - Street 2:MIDDLESEX HOSPITAL, DEPARTMENT OF PSYCHIATRY
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-3654
Mailing Address - Country:US
Mailing Address - Phone:860-358-6497
Mailing Address - Fax:860-358-6850
Practice Address - Street 1:28 CRESCENT STREET
Practice Address - Street 2:MIDDLESEX HOSPITAL, DEPARTMENT OF PSYCHIATRY
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-3654
Practice Address - Country:US
Practice Address - Phone:860-358-6497
Practice Address - Fax:860-358-6850
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2009-05-22
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Provider Licenses
StateLicense IDTaxonomies
CT0437192084D0003X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084D0003XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyDiagnostic Neuroimaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT043719OtherCT DEP'T HEALTH