Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jonathan Douglas Heaven, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1114629755

Jonathan Douglas Heaven, MD is a Student in an Organized Health Care Education/Training Program in Atlanta, Georgia. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

12 Executive Park Dr NE Ste 200
Atlanta, GA 30329-2206
Phone: (404) 712-6934
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1114629755
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 20, 2023
Last updated in NPPESJuly 30, 2026
Certification dateJuly 30, 2026

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