DR. JACK HEETHOUSE D.O. NPI 1679523674

NPI Information

  • NPI: 1679523674
  • Provider Name: DR. JACK HEETHOUSE, D.O.
  • Classification: Specialist - 174400000X
  • Entity Type: Individual
  • Address: 1400 MERCY DR.
    SUITE 100
    MUSKEGON, MI
    ZIP 49444
  • Phone: (231) 733-1326

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NPI Details

DR. Jack Heethouse, D.O. is a specialist in Muskegon, MI. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. Jack Heethouse, D.O. NPI is 1679523674. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1400 MERCY DR.
SUITE 100
MUSKEGON, MI
ZIP 49444
Phone: (231) 733-1326
Fax: (231) 733-5212

The enumeration date for this NPI number is 5/11/2006 and was last updated on 11/13/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist5101012999MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1H40569MEDICARE UPINMICHIGAN
24308380MEDICAIDMICHIGAN
3ON30160MEDICARE ID-TYPE UNSPECIFIEDMASSACHUSETTSMEDICARE PROVIDER #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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