Healthcare Provider Details

I. General information

NPI: 1548299431
Provider Name (Legal Business Name): CARDIOVASCULAR & THORACIC SURGEONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 10/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4030 SMITH RD SUITE 300
CINCINNATI OH
45209-1957
US

IV. Provider business mailing address

4030 SMITH RD SUITE 300
CINCINNATI OH
45209-1957
US

V. Phone/Fax

Practice location:
  • Phone: 513-421-3494
  • Fax: 513-345-2606
Mailing address:
  • Phone: 513-421-3494
  • Fax: 513-345-2606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. S RUSSELL VESTER
Title or Position: CHAIRMAN, BOARD OF DIRECTORS
Credential: M.D.
Phone: 513-421-3494