Provider Demographics
NPI:1700987096
Name:HEBB, DONALD (DPM)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:HEBB
Suffix:
Gender:M
Credentials:DPM
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 449
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-0449
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1600 MURDOCH AVE STE 100
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-3248
Practice Address - Country:US
Practice Address - Phone:304-485-8040
Practice Address - Fax:304-485-4883
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002364213ES0131X
WV287213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0099593000Medicaid
WV0099593000Medicaid
OHP00458311OtherRRMCR
OH4216161Medicare PIN
OH7419911Medicare PIN
OH0661270Medicaid
OH5979250001Medicare NSC
OH000000525662OtherANTHEM
OH5979250001Medicare NSC
OH7419911Medicare PIN