MEDICARE: STV CARDIOTHORACIC SURGEONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician

General Provider Information

NPI Number	:	1649624255
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STV CARDIOTHORACIC SURGEONS LLC

Provider Business Mailing Address
First Line	:	50 MEDICAL PARK DR E
Second Line	:	BLDG 46, STE 310, FINANCE
City	:	BIRMINGHAM
State	:	AL
Zip	:	35235-3401
Country	:	US
Telephone Number	:	205-838-5286
Fax Number	:

Provider Business Practice Location Address
First Line	:	3056 HEALTHY WAY STE 100
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35243-2435
Country	:	US
Telephone Number	:	205-930-2925
Fax Number	:

Authorized Official
Title or Position	:	VP REVENUE CYCLE
Name	:	KYLE HUPACH
Credential	:
Telephone Number	:	205-731-9287

Provider Enumeration Date	:	04/20/2016
Last Update Date	:	05/19/2026

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