Hettich, Thomas Glen

Hettich, Thomas Glen is an individual health care provider with primary practice located at 3250 Zemke Ave Attn: Soccent Clinic, Tampa FL 33621-5023. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Hettich, Thomas Glen can be contacted via phone (813) 827-9213.

Contact Information

Primary practice address
3250 Zemke Ave Attn: Soccent Clinic Tampa FL 33621-5023
Phone: (813) 827-9213
Fax: (813) 827-1319
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9108323 Florida

Profile Details

NPI number 1992765747
LBN Legal business name Hettich, Thomas Glen
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2006
Last updated Feb 19th, 2016 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992765747 NPPES
Other 1049243 NCCPA CERTIFICATION NUM

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