| Doctor Name: | MR. JEFFERY LEE HEILESON |
| NPI Number: | 1124354204 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RD, LD |
| License Number: | LD003650 |
| Business Practice Address: | 650 Joel Dr Fort Campbell, KY - 422235318 |
| Business Phone Number: | 2709560621 |
| Business Fax Number: | |
| Mailing Address: | 1501 Mutual Dr, CLARKSVILLE |
| State: | TN |
| Postal Code: | 370427092 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 10/26/2009 |
| NPI Last Update Date: | 09/03/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | LD003650 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |