Healthcare Provider Details

I. General information

NPI: 1164432852
Provider Name (Legal Business Name): THORACIC CARDIAC & VASCULAR SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 02/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 PRINCETON AVE SW POB II, SUITE 300
BIRMINGHAM AL
35211-1333
US

IV. Provider business mailing address

817 PRINCETON AVE SW POB II, SUITE 300
BIRMINGHAM AL
35211-1333
US

V. Phone/Fax

Practice location:
  • Phone: 205-780-8980
  • Fax: 205-785-1554
Mailing address:
  • Phone: 205-780-8980
  • Fax: 205-785-1554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: LEE SHEFTON RIGGINS
Title or Position: CEO
Credential: M.D.
Phone: 205-780-8980