1881890598 NPI number — CARDIOLOGY ASSOCIATES OF NATCHEZ

Table of content: (NPI 1881890598)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881890598 NPI number — CARDIOLOGY ASSOCIATES OF NATCHEZ

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARDIOLOGY ASSOCIATES OF NATCHEZ
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NATCHEZ REGIONAL MEDICAL CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881890598
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
140 JEFFERSON DAVIS BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NATCHEZ
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39120-5104
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
601-304-9718
Provider Business Mailing Address Fax Number:
601-304-9637

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
140 JEFFERSON DAVIS BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NATCHEZ
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39120-5104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-304-9718
Provider Business Practice Location Address Fax Number:
601-304-9637
Provider Enumeration Date:
06/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GAUTHIER
Authorized Official First Name:
TAMRA
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLING SUPERVISOR
Authorized Official Telephone Number:
225-924-9827

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1598707150 . This is a "NPI" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: 37396 . This is a "MS LICENSE NUMBER" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com