Healthcare Provider Details

I. General information

NPI: 1972560225
Provider Name (Legal Business Name): CARDIOLOGY CONSULTANTS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 06/04/2020
Certification Date: 06/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1083 BOILING SPRINGS RD
SPARTANBURG SC
29303-2298
US

IV. Provider business mailing address

1083 BOILING SPRINGS RD
SPARTANBURG SC
29303-2298
US

V. Phone/Fax

Practice location:
  • Phone: 864-583-8647
  • Fax: 864-699-4179
Mailing address:
  • Phone: 864-583-8647
  • Fax: 864-699-4179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH E. MOBLEY
Title or Position: PRESIDENT
Credential:
Phone: 864-583-8647