Provider Demographics
NPI:1730198060
Name:HECKERT, WILLIAM FRANK (DO)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:FRANK
Last Name:HECKERT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:2815 S PENNSYLVANIA AVE
Mailing Address - Street 2:STE 107
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-3496
Mailing Address - Country:US
Mailing Address - Phone:517-372-2253
Mailing Address - Fax:517-372-2287
Practice Address - Street 1:2815 S PENNSYLVANIA AVE
Practice Address - Street 2:STE 107
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-3496
Practice Address - Country:US
Practice Address - Phone:517-372-2253
Practice Address - Fax:517-372-2287
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101006399207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI03-00584OtherPHP
MI0753335364OtherBLUE CROSS
MIE26883Medicare UPIN
MI5333536Medicare ID - Type Unspecified