SOUTHEASTERN CARDIOLOGY NPI 1396944633

NPI Information

NPI: 1396944633
Provider Name: SOUTHEASTERN CARDIOLOGY
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
1811 EDWINA DR
VIDALIA, GA
ZIP 30474
Phone: (912) 537-8988
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SOUTHEASTERN CARDIOLOGY is a cardiovascular disease internal medicine in Vidalia, GA. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. SOUTHEASTERN CARDIOLOGY NPI is 1396944633. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1811 EDWINA DR
VIDALIA, GA
ZIP 30474-963
Phone: (912) 537-8988
Fax: (912) 608-8037

The provider's authorized official is Deborah Grace Elliott-smith .
The authorized official title is Practice Manager and has the following contact phone number (912) 537-8988.

The enumeration date for this NPI number is 7/17/2007 and was last updated on 7/17/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease	53388	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	E75547	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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