Individual provider · Type 1 NPI
Larry Travis Heap, PA-C
Medical Physician Assistant · St. Johns, AZ
NPI number
1366418113
Active
Practice location
625 N 13th W
St. Johns, AZ 85936-4986
Fax (928) 532-3561
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 3048 (AZ) |
Medical Physician Assistant: Definition to come...
3 other providers at this address
About NPI 1366418113
Larry Travis Heap, PA-C's National Provider Identifier is 1366418113, issued on Feb 23, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in St. Johns, AZ. The record was last updated on Sep 9, 2026.