Healthcare Provider Details

I. General information

NPI: 1437257870
Provider Name (Legal Business Name): APPALACHIAN HEART CENTER, PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 01/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MEDICAL CENTER DR SUITE 2 A
HAZARD KY
41701-9466
US

IV. Provider business mailing address

200 MEDICAL CENTER DR SUITE 2 A
HAZARD KY
41701-9466
US

V. Phone/Fax

Practice location:
  • Phone: 606-439-4433
  • Fax: 606-487-8035
Mailing address:
  • Phone: 606-439-4433
  • Fax: 606-487-8035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. VIDYA B YALAMANCHI
Title or Position: OWNER
Credential: M.D.
Phone: 606-439-4433