Healthcare Provider Details
I. General information
NPI: 1871566091
Provider Name (Legal Business Name): HEART AND VASCULAR CLINIC, APMC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
64040 HIGHWAY 434 SUITE 200
LACOMBE LA
70445-3456
US
IV. Provider business mailing address
64040 HIGHWAY 434 SUITE 200
LACOMBE LA
70445-3456
US
V. Phone/Fax
- Phone: 985-892-9233
- Fax: 985-892-8916
- Phone: 985-892-9233
- Fax: 985-892-8916
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JAMES
EMERSON
SMITH
III
Title or Position: PRESIDENT
Credential: MD
Phone: 985-892-9233