Heethouse, Jack
Heethouse, Jack is an sole proprietor health care provider with primary practice located at 1400 Mercy Dr. Suite 100, Muskegon MI 49444. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Heethouse, Jack can be contacted via phone (231) 733-1326.Contact Information
Primary practice address
1400 Mercy Dr. Suite 100
Muskegon MI 49444
Phone: (231) 733-1326
Fax: (231) 733-5212
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 5101012999 | Michigan |
Profile Details
| NPI number | 1679523674 |
|---|---|
| LBN Legal business name | Heethouse, Jack |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 11th, 2006 |
| Last updated | Nov 13th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679523674 | NPPES |
| Michigan | MEDICAID | 4308380 |
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