Healthcare Provider Details
I. General information
NPI: 1871549964
Provider Name (Legal Business Name): CARDIO-THORACIC SURGEONS, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/26/2006
Last Update Date: 09/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2871 ACTON ROAD SUITE 100
BIRMINGHAM AL
35243-2560
US
IV. Provider business mailing address
2871 ACTON ROAD SUITE 100
BIRMINGHAM AL
35243-2560
US
V. Phone/Fax
- Phone: 205-939-0023
- Fax: 205-939-0293
- Phone: 205-939-0023
- Fax: 205-939-0293
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOHN
L
HARLAN
Title or Position: PRESIDENT
Credential: MD
Phone: 205-939-0023