Heidi Dearborn, DO | |
1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | |
(210) 292-5350 | |
Not Available |
Full Name | Heidi Dearborn |
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Gender | Female |
Speciality | Dermatology |
Location | 1100 Wilford Hall Loop, Jbsa Lackland, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003317744 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207N00000X | Dermatology | DO2964 (Maine) | Primary |
Entity Name | Epiphany Dermatology Of Arizona Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1457465858 PECOS PAC ID: 9830181361 Enrollment ID: O20040402000307 |
Mailing Address | Practice Location Address |
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Heidi Dearborn, DO 7300 Ranch Road 2222, Building 1, Ste 200, Austin, TX 78730 Ph: (512) 628-0465 | Heidi Dearborn, DO 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 Ph: (210) 292-5350 |
Dr. Christopher M Edens, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236 Phone: 210-292-6225 | |
Dr. Emily Beth Wong, M.D. Dermatology Medicare: Medicare Enrolled Practice Location: 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236 Phone: 210-292-8808 | |
Dr. Wendi Wohltmann, M.D. Dermatology Medicare: Medicare Enrolled Practice Location: 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236 Phone: 210-292-5350 | |
Shannon Patrick Buck, D.O. Dermatology Medicare: Medicare Enrolled Practice Location: 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236 Phone: 210-292-8200 Fax: 210-292-3781 | |
Dr. Marie J Han, MD Dermatology Medicare: Medicare Enrolled Practice Location: 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236 Phone: 210-292-8808 |