David Heriford, PA
Individual provider Active NPI Physician Assistant · Virginia, IL
NPI 1992750236 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992750236
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 331 S Main St
Virginia, IL 62691-1519 - Phone
- (217) 452-3507
- Fax
- (217) 452-7245
- NPI assigned
- May 24, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085002440 | IL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peninsula Community Health Services | Physician Assistant | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | IL | Yes |
Addresses
Primary practice location
331 S Main St
Virginia, IL 62691-1519
Mailing address
331 S Main St
Virginia, IL 62691-1519
Phone (217) 452-3507
Other providers in Virginia, IL
- Cass County Public Health Dept
- Cass County School Health Center
- Cass County Senior Living & Rehabilitation LLC
- Dirck A Curry
- Emily Eichelberger
- Jack Dee Hollada
- Hayley J Jones
- Matthew Aaron Lynch
- Mecca Paramedics, Inc
- Moreland & Devitt Inc
All providers in Virginia, IL · Physician Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.