Heston, Jerry D
Heston, Jerry D is an individual health care provider with primary practice located at 1135 Cully Rd Ste 100, Cordova TN 38018-8503. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Heston, Jerry D can be contacted via phone (901) 758-1980.Contact Information
Primary practice address
1135 Cully Rd Ste 100
Cordova TN 38018-8503
Phone: (901) 758-1980
Fax: (901) 309-8784
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 014992 | Tennessee |
Profile Details
| NPI number | 1316054422 |
|---|---|
| LBN Legal business name | Heston, Jerry D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 24th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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 | 1316054422 | NPPES |
| Tennessee | MEDICAID | 3015362 |
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