Search › Idaho › 207RG0100X
Trace Heavener, D.O
NPI 1841646726 · on the registry since 2016
Practice
- Address
- 1919 Lincoln Way Ste 415
Coeur D Alene, ID 83814 - Phone
- (208) 625-4595
- Fax
- (208) 625-4596
- Clinicians at this address
- 63
Registry record
- Primary taxonomy
- 207RG0100X
207RG0100X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-05-06
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho